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신증후군과 말초 신경증으로 발현된 원발성 전신성 유전분증 1예
이상호,김병준,최선희,이성주,배윤상,양윤식,고영재,이능아,이지혁,조만종 대한신장학회 1997 Kidney Research and Clinical Practice Vol.16 No.3
Primary systemic amyloidosis is a progressive disease that is frequently fatal. Nephrotic syndrome is present in almost one-third, congestive heart failure in one-quarter, and peripheral neuropathy in one-sixth of patients at the time of diagnosis. If heart or renal failure are presented, survival rate is poor. We experienced a case of a 66 year-old fernale patient who had complained lower leg edema and paresthesia of extremities for about 5 rnonths. The laboratory findings were consistent with nephrotic syndrome, but the lower leg edema was non-pitting and the cause of paresthesia was unknown. We perforrned kidney and nerve biopsy and confirmed a case of primary systemic arnyloidosis. In this case, presence of postural hypotension, probable cardiac involvement and relatively long spikes along the outside of the glomerular capillary loops on methenamine silver stain is suggestive of poor prognosis. We can predict chronic renal failure and congestive heart failure in the course of this case. We report a case of primary systemic amyloidosis predominantly presenting nephrotic syndrome and peripheral neuropathy with review of related literatures.