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Currently filtering by tag: ALECT2

ALECT2 Amyloidosis

ALECT2 Amyloidosis, arkana laboratories, renal pathology
The patient is a 75-year-old Hispanic male who presents with progressively worsening kidney function and a creatinine of 1.6 mg/dl (baseline 1.0 mg/dl). His physician called for a biopsy due to a slowly "creeping" creatinine over the last 8 months. Images 1 & 2 show "apple-green birefringence" on a Congo red stain under polarized light within the interstitium. Image 3 shows mild interstitial fibrosis. Image 4 shows a normal glomerulus on PAS stain and Image 5 shows positive immunohistochemical staining with Lect2. Leukocyte cell-derived chemotaxin 2 (ALECT2) amyloidosis preferentially affects Hispanics (particularly Mexicans) as well as Punjabis, First Nations people...

Pushing Glass (April 6, 2018)

Amyloidosis, ALect2-Type, arkana laboratories, pushing glass
A 75-year-old Hispanic male presents with a creatinine of 3. His creatinine has slowly been creeping up over the last year from 1.8 to the current level. No hematuria or proteinuria is reported. Serologies for ANA, dsDNA, rheumatoid factor, hepatitis B, hepatitis C, and ASO are negative. Complement levels are normal. SPEP and UPEP are within normal limits. What is the best diagnosis? A. Arterionephrosclerosis B. Amyloidosis, AL-Type C. Amyloidosis, AA-Type D. Amyloidosis, ALect2-Type   The best answer is D (Amyloidosis, ALect2-Type). From low power, the glomeruli have an ischemic appearance and the arteries have severe arteriosclerosis. However, the Congo...


Photomicrographs show extensive interstitial and glomerular deposition of Congo red positive material that stains positive for LECT2. Despite being one of the most recently described amyloid proteins, amyloid composed of leukocyte chemotactic factor 2 (ALECT2) is actually quite prevalent. Two large case series focusing on renal amyloidosis have identified ALECT2 as one of the most common forms of amyloidosis involving the kidney along with AL and AA amyloid.1-4 Additionally, a large case series in the liver identified it as the second most common form of hepatic amyloidosis.5 The vast majority of patients suffering from this disease in the United States...