SENILE PLAQUES AND TANGLES IN DIALYSIS DEMENTIA

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Abstract
The brains of 7 patients treated with hemodialysis were studied. Patients (4) had dialysis encephalopathy syndrome (DES). Senile plaques and or neurofibrillary tangles were found in 5 of 7 cases, 3 with and 2 without DES. One case of each group had plaques to an extent compatible with that in Alzheimer''s disease, though of a different distribution. Neurofibrillary tangles were sparse. Plaques and tangles containing paired helical filaments were the principal changes in Alzheimer''s disease. Al was implicated as a possible etiologic agent behind the paired helical filaments in Alzheimer''s disease where raised cerebral Al contents were demonstrated. Al increased in CNS and also in DES, most likely as a consequence of procedures in connection with hemodialysis. The finding of neurofibrillary tangles and senile plaques in hemodialyzed patients, some of which developed DES, may support the theories concerning Al as an etiological agent for cerebral changes in Alzheimer''s disease.