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- Published: January 16, 2018
- By: Alejandro Best, MD
- Tags: Acute kidney injury, Amyloidosis, Apple-green birefringence, Congo red, Fibrinogen A-alpha amyloidosis, Proteinuria, Rare renal disease
A 65-year-old male, with no significant past medical history, presents with proteinuria and worsening renal function. The serum creatinine is 2.4 mg/dl and the UPCR is 2.5 g/g. Serum and urine protein electrophoresis with immunofixation shows the absence of monoclonal immunoglobulin. Free serum light chain ratio is within normal limits. Remaining of serologies are also negative/normal. A renal biopsy was performed and representative images are shown (Fig 1-5). The glomeruli are markedly enlarged and show massive deposition of PAS-pale (Fig 1), weakly argyrophilic (Fig 2), Congo red positive (Fig 3) amorphous material which shows apple green birefringence upon polarization (Fig...