FEATURES OF AMYLOIDOSIS OF LIVER AND OTHER ORGANS AS REVEALED BY AUTOPSIES
Abstract
Background. Amyloidosis is a stromal vascular dystrophy accompanied by formation of an abnormal proteinpolysaccharide complex (amyloid) in various organs, which life-time diagnosis is difficult. Objective. To assess the prevalence of amyloidosis among the residents of Grodno Province by retrospectively studying autopsy protocols and to reveal morphological features of the liver and other organs damage.
Materials and methods. We retrospectively analyzed autopsy protocols of 34,150 subjects – residents of Grodno Province – who died in hospital or at home in 2004 – 2016 years.
Results. According to the autopsy data the prevalence of amyloidosis was 0.1%. Primary amyloidosis occurred in 30.3% cases, while secondary amyloidosis was present in 69.7% cases. In most cases secondary amyloidosis was due to rheumatoid polyarthritis and chronic inflammatory pulmonary diseases. Localized amyloidosis confined to kidneys was revealed in 5 cases (15.2%), generalized amyloidosis was present in 28 (84.8%) cases. Amyloidosis most commonly affected kidneys (97.0%), spleen (69.7%) and liver (60.6%). All cases of liver amyloidosis were accompanied by the involvement of other organs in the same process such as kidneys (92.9%), spleen (71.4%) and heart (57.1%). In primary amyloidosis the liver was involved in 90.0% cases, while in secondary amyloidosis only in 47.8% (p<0.05) cases. Diffuse lesion of the liver was present in 25% cases, in 75% cases only portal tracts were affected. In the former type all patients had signs of portal hypertension and in 40% cases there was low-grade jaundice. In the latter type there were no clinical and morphological features of hepatocellular insufficiency or portal hypertension.
Conclusion. Renal biopsy is the most effective method of amyloidosis diagnosis as the kidneys are most commonly and intensively involved. Hepatic amyloidosis occurrs less common and in 75% cases is a focal process. Liver biopsy is advisable when hepatosplenomegaly without previous liver history and nephrotic syndrome is present.
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