Beta 2-microglobulin amyloidosis in chronic dialysis patients

Dialysis-related amyloidosis secondary to beta-2-microglobulin (beta 2m) deposits is a common complication of long-term dialysis patients and is responsible for significant morbidity with potential mortality. Beta 2m amyloid has a propensity to deposit in the osteoarticular tissues, particularly in large bones close to the joint spaces, and in synovial membranes and carpal tunnel tissue. Older age at the onset of dialysis and the duration of dialysis are two important risk factors for development of this disease. The high-flux, more biocompatible membranes have been shown to remove and adsorb beta 2m more efficiently than the cellulosic membranes. This study presents the case of a chronic dialysis patient who developed recurrent arthritis of the left knee, followed by carpal tunnel syndrome; biopsy of the patient's knee showed very large aggregates of beta 2m amyloid deposits in the tendon sheets. A brief review of the literature on this subject is also presented.