학술논문

Dialysis-related Amyloidosis Presenting as a Fever of Unknown Origin: Symptoms and Management
Document Type
Journal Article
Source
Internal Medicine. 2023, 62(24):3669
Subject
dialysis-related amyloidosis
fever of unknown origin
hemodiafiltration
β2-microglobulin
Language
English
ISSN
0918-2918
1349-7235
Abstract
A 74-year-old woman with a 34-year history of hemodialysis presented with an intermittent fever, which later coincided with recurrent bilateral shoulder and hip joint pain. Imaging studies suggested amyloid arthropathy, which was histologically confirmed by a synovial biopsy. Increasing β2-microglobulin clearance during dialysis alone attenuated the intermittent fever and joint pain, but the symptoms did not disappear until the administration of prednisolone 10 mg/day. Reported cases of dialysis-related amyloidosis with a fever imply that changing to blood purification methods with high β2-microglobulin clearance is crucial for controlling the condition long-term, whereas concurrent use of anti-inflammatory agents promptly alleviates the symptoms.