Amyloid arthropathy in patients on regular dialysis: A newly discovered disease

Amyloid arthropathy is a newly discovered complication observed in patients on regular dialysis treatment. It is due to an abnormal deposition of β/sub 2/-micro-amyloid fibrils in synovia and bone structure. The authors present the radiographic evaluation of 286 patients treated in three different dialysis units. The most relevant radiologic aspects are cystic radiolucencies of bone, which result from local amyloid deposition, involving carpal bones and humeral and femoral heads as the main targets. The frequency of these findings was as follows: carpal bones, 16%; humeral heads, 29%; femoral heads, 28%. In three patients amyloid deposition was also found in the synovia of the carpal tunnels; in two additional patients articular synovial biopsy tissue examined with immunocytochemical analysis and optical and electron microscopy showed β/sub 2/ deposition in the amyloid fibrils. In conclusion, amyloidosis is a frequent and new complication of regular dialysis, and β/sub 2/-microglobulin appears to be a new uremic toxin