β 2 ‐Microglobulin Amyloidosis in Hemodialysis Patients An Autopsy Study of Intervertebral Disks and Posterior Longitudinal Ligaments

Ninety‐five autopsy cases of chronic renal failure, which had or had not been treated by hemodialysis, were examined histologically and immunohistochemically for evidence of amyloid deposition in the intervertebral disks and posterior longitudinal ligaments of the spine, β 2 ‐Microglobulin (β 2 M) amyloid was not present in non‐dialyzed patients with chronic renal failure. In cases showing β 2 M amyloid deposition, the shortest term of hemodialysis was 2 years and 5 months. The incidence of β 2 M amyloidosis tended to increase as the dialysis period was prolonged. An inverse correlation was present between dialysis period and age in 22 cases showing β 2 M amyloid deposition (correlation coefficient: –0.43, p<0.05), and β 2 M amyloidosis tended to occur earlier in elderly patients than in younger patients. This suggests that elderly patients are more susceptible to &M amyloidosis. β 2 M amyloid was absent in all of 8 cases of systemic lupus erythematosus which were treated by dialysis for periods ranging from 2 days to 12 years. In these patients, β 2 M amyloidosis may have been prevented by steroids, which had been administered for long periods in all cases. Another amyloid of unknown composition was also frequently present in the intervertebral disks and posterior longitudinal ligaments not only in patients with chronic renal failure but also control patients without chronic renal failure. This amyloid was immunohistologically negative for β 2 M, amyloid A protein, light chain kappa or lambda, prealbumin, and apolipoprotein All. Acta Pathol Jpn 40: 820 826, 1990.