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Anti-TNF-α therapy for renal amyloid as a complication of Crohn's disease.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Blackmur, James P. Chapman, Frances A. Bellamy, Christopher O. Save, Vipul Plevris, J. N. Shand, Alan G. Whitworth, Caroline E. Dhaun, Neeraj |
| Copyright Year | 2014 |
| Abstract | ### Learning Point for Clinicians Renal amyloid is a rare complication of Crohn’s disease (CD). Increased mortality is associated with increased serum amyloid A (SAA) protein concentration and reducing SAA improves survival. Anti-TNF-α may treat both renal amyloid and CD. NSAID use may precipitate a CD flare. Collagenous colitis is associated with CD and amyloidosis. A 35-year-old butcher was admitted from the renal outpatient clinic for investigation and management of worsening peripheral oedema. He gave a past history of Crohn’s disease (CD). This had been asymptomatic for many months and so the patient had weaned himself of immunosuppression (azathioprine) 4 months earlier. On admission, serum albumin was <4 g/l (normal range 30–45) with proteinuria of ∼20 g/d (0–30 mg/d). Serum creatinine was normal—41 µmol/l (40–125); C-reactive protein (CRP) was 23 mg/dl (0–5). Following a diagnosis of severe nephrotic syndrome, a renal biopsy was performed. This demonstrated AA amyloid (Figure 1A). Upper and lower gastrointestinal endoscopies showed no active inflammation. The patient was optimized on standard therapy for his nephrotic syndrome—maximal doses of an angiotensin converting enzyme inhibitor and angiotensin receptor blocker alongside … |
| File Format | PDF HTM / HTML |
| DOI | 10.1093/qjmed/hct112 |
| PubMed reference number | 23681221 |
| Journal | Medline |
| Volume Number | 107 |
| Issue Number | 1 |
| Alternate Webpage(s) | https://watermark.silverchair.com/hct112.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAkIwggI-BgkqhkiG9w0BBwagggIvMIICKwIBADCCAiQGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM4KuVrtJ1WAk9VwlmAgEQgIIB9RYvYFS91AShtN943ajw7W-UnKHa-pmyxHSGiQqdmYKrwQgiEKyeC4a5kGHOQZWS7WX0027_v4LYUxhoUzAUCQfaOYe7q0QSxo6QnMMTdm1aEgHCBIlsETit_dBEjKOdT-EPmTm9tmjCaolXZb1tl_BwfOmYvOolDKwthPZtM_LD-CfFC5OsexUbJudvY1W4zH4rwZqGJQW890aHlBM2qGNbSfsCQd0JPIzCQJeWyQtfSsg5mekcel23Z2tttQmyis5JZkfObqZttKw5D9fZcXhQiCrjTRJrvQJorGrq9zx_uqJVkcreJFJIxeZ_oug_6djiJP0WH0YrhmOKO9F2f_EMXkubSiymiRgV_iNeE3FG4XJDwyDlYF2_YimloCjuinW3uMoax3yTHoEQnX5ecI4DxjXlkV3bfnTQWbCn_hIEJq5m7b_1qbO_ZEYpDdCcynPiOmeuSfCFYSuqmGA7qWOMoI5Fjv_GUbQ8-4c1gVsMLZlZMpdrC9XLGV5kD_k3mwE88kz3DFatFuuuygnpKsbx45ANzzZka2aNsRatmIo6cvtomZgfe82a69TPaObpgoow65082LV1N3brwtHX3Rc4l_LL4RKYVQwLpyt4HiEjSQnJNNlKZi689pyfLKKHIDNbAFqSiQwZb6dKQ71WNlvaG3So4g |
| Alternate Webpage(s) | https://doi.org/10.1093/qjmed%2Fhct112 |
| Journal | QJM : monthly journal of the Association of Physicians |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
