beta(2)-Microglobulin amyloidosis caused spinal cord compression in a long-term haemodialysis patient.

Abstract:

STUDY DESIGN:A case report of cervical myelopathy caused by epidural beta (2)-microglobulin (beta2m) amyloid deposits in a 50-year-old woman with haemodialysis treatment. OBJECTIVE:Long-term haemodialysis in patients with end-stage renal disease leads to several complications based on beta2m deposits, which can affect, in the cervical spine, the intervertebral disk, and in rare cases, they may compress the spinal cord and nerves. The objective of this report is to describe the clinical and radiological follow-up preceding the indispensable surgical excision of an amyloid mass in a 50-year-old woman with haemodialysis treatment. Long-term postoperative cervicalgia owing to subcondylian bone cyst-associated atlanto-occipital instability is also described and discussed. SETTING:Department of Neurosurgery A, Hop Pellegrin, Bordeaux, France. CASE REPORT:We present a clinical case of a patient with spinal cord compression. The patient was treated by surgical excision of an amyloid mass subsequent to a C2-C3 laminectomy. The patient experienced clinical improvement with a regression of all of her neurological symptoms. Histological findings confirm the diagnosis of beta2m amyloid deposition. However, 5 years after surgery the subcondylian bone cysts were still observed and atlanto-occipital instability required her to wear a minerva. CONCLUSION:Our case report confirms that surgical excision of beta2m epidural deposits is necessary and relevant when neurological prognosis is discussed, and that pain is still the major symptom of disease evolution. The use of high-flux synthetic membranes could decrease the beta2m blood level and early renal graft is the only method to prevent such complications.

journal_name

Spinal Cord

journal_title

Spinal cord

authors

Vignes JR,Eimer S,Dupuy R,Donois E,Liguoro D

doi

10.1038/sj.sc.3101969

subject

Has Abstract

pub_date

2007-04-01 00:00:00

pages

322-6

issue

4

eissn

1362-4393

issn

1476-5624

pii

3101969

journal_volume

45

pub_type

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