Development of Gastrointestinal β2-Microglobulin Amyloidosis Correlates With Time on Dialysis

Publisher Website
Google Scholar
Abstract
Dialysis-associated β2-microglobulin (β2m) amyloidosis affects predominantly musculoskeletal tissue, but visceral involvement also occurs. To evaluate the clinical significance and prevalence of gastrointestinal β2m amyloidosis, we studied hemodialysis patients admitted for gastrointestinal-related complaints. Hemodialysis patients (excluding those with non-β2m amyloidosis) who were admitted with gastrointestinal complaints from 1984 to 1994 were identified. Gastrointestinal tissues from patients with available autopsy or surgical specimens were examined using hematoxylin and eosin stain, Congo red stain, and β2m immunostain. Each case was evaluated independently by two pathologists and scored for quantity and location of β2m amyloid and associated pathology. Of 24 patients, eight (four men and 4 women) had β2m amyloid deposits within the gastrointestinal tract. Acute clinical presentation ranged from abdominal pain to gastrointestinal bleeding and was not significantly different for patients with or without gastrointestinal β2m amyloid deposits. However, the mean time on dialysis of 15.3 ± 5.7 years (range 6-24 years) for patients with gastrointestinal β2m amyloidosis was significantly greater than that of patients without gastrointestinal β2m amyloidosis (10.5 ± 7.0 years, range