J Clin Neurol.  2009 Sep;5(3):146-148. 10.3988/jcn.2009.5.3.146.

Secondary Amyloidosis Associated with Multiple Sclerosis

• Kang SJ
• Yi JH
• Hong HS
• Jang SH
• Park MH
• Kim HJ
• Lee KY
• Lee YJ
• Han SW
• Koh SH

• KMID: 2045421
• DOI: http://doi.org/10.3988/jcn.2009.5.3.146

Abstract

BACKGROUND
Multiple sclerosis (MS) is a demyelinating disease of the central nervous system. Secondary amyloidosis can occur as a complication of chronic systemic inflammatory and infectious diseases. Until now there has been no report of secondary amyloidosis associated with MS. We report herein a case of renal biopsy-proven secondary amyloidosis in a patient with MS. CASE REPORT: A 41-year-old woman with MS was hospitalized due to aggravated quadriparesis and edema in both lower extremities. Laboratory findings showed nephrotic-range proteinuria and hypoalbuminemia. A percutaneous renal biopsy procedure was performed, the results of which revealed secondary amyloid-A-type amyloidosis associated with MS. CONCLUSIONS: This is the first report of secondary amyloidosis associated with MS.

Keyword

multiple sclerosis; secondary amyloidosis; nephrotic syndrome

MeSH Terms

Adult
Amyloidosis
Biopsy
Central Nervous System
Communicable Diseases
Demyelinating Diseases
Edema
Female
Humans
Hypoalbuminemia
Lower Extremity
Multiple Sclerosis
Nephrotic Syndrome
Proteinuria
Quadriplegia

Figure

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  Fig. 1 MRI and microscopic findings. A: Fluid-attenuated inversion recovery sequence on MRI showing three plaques in the brain, and T2-weighted MRI showing severe atrophy of the cervical and thoracic cord. B: On light microscopy, the glomerulus exhibits extensive effacement of the glomerular architecture by large, irregularly shaped, amorphous, weakly periodic acid-Schiff (PAS)-positive, amyloid deposits (PAS ×400). C: Strongly Congoredpositive materials can be seen in the glomeruli and arterioles (Congoed, ×400). D: Amyloid deposits are positive on immunohistochemical staining for AA. E: Note the large nodular mesangial deposition of nonbranching, thin fibrils, ranging from 8.33 to 13.1 nm in thickness (electron micrograph, ×25,000).

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