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Nodular pulmonary amyloidosis and Sjögren's syndrome in a patient treated with intermittent hemodialysis
Author(s) -
NIEPOLSKI Leszek,
GRZEGORZEWSKA Alicja E.,
SZYMAŚ Janusz
Publication year - 2007
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2007.00209.x
Subject(s) - medicine , hemodialysis , amyloidosis , surgery , dermatology , intensive care medicine
In the available literature, we have found the descriptions of 5 cases of nodular pulmonary amyloidosis associated with Sjögren's syndrome. In our practice, such a case has occurred in a patient with chronic renal failure. A 53‐year‐old woman underwent nephrological, rheumatological, and pulmonological examinations because of end‐stage renal disease with a small cirrhotic kidney in renal ultrasound examination, pulmonary nodules, and xerophthalmia. Serological data revealed a slightly positive rheumatoid factor, antinuclear antibodies, anti‐SS‐A, anti‐SS‐B, and anti‐RNP/Sm antibodies. Schirmer's test was positive on both sides and Sjögren's syndrome was recognized. Pulmonological examinations (the chest radiograph and CT scan, bronchofiberoscopy, culture of bronchial washings, bronchial biopsy, pleural effusion analysis, and a thick‐needle biopsy) failed to determine the etiology of nodular changes in lungs. Immunofluorescence studies in the skin biopsy specimen showed IgM‐positive staining. After 2 years of treatment with IHD, a toracoscopy was performed with enucleation of the nodules from the right lung. Histological examination showed massive deposits of amyloid, which allowed for a diagnosis of diffusive nodular pulmonary amyloidosis.