A clinical study of amyloid osteoarthropathy in hemodialysis patients and radiolucent carpal bone cysts

• Published in: Journal of Japanese Society for Dialysis Therapy Vol. 22; no. 11; pp. 1183 - 1188
• Main Authors: Takenaka, Akira, Kuwabara, Kazunori, Komatsu, Fumito, Miyamoto, Tadayuki, Hashimoto, Hitofumi, Terao, Naotami, Yamamoto, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society for Dialysis Therapy 1989
• Subjects: carpal tunnel syndrome; cystic raiolucency; dialysis related amyloidosis
• ISSN: 0911-5889; 1884-6211
• DOI: 10.4009/jsdt1985.22.1183

In order to elucidate the relation between dialytic amyloidosis and cystic radiolucency (CRL), we studied factors such as age, history of dialysis, disorder underlying chronic renal insufficiency, Ulnar variance, and hemato logic parameters by dividing CRL of carpal bones into 4 groups. Multivariate analysis was used to show effects of cyst forming factors. Subjects were 150 patients (85 males and 65 females of 53.5 years receiving dialysis for 71.9 months. Healthy 6 adults (13 males and 23 females) were selected as controls. Positive CRL was significantly more frequently found in the patients (34.7%) than in the controls (19.4%). The incidence in patients with complicating carpal tunnel syndrome was 87.5%. Mean onset age tended to be older with more serious CRL. Dialysis period was significantly longer in group 4 but no significant differences were found among the three remaining groups. Patients receiving dialysis for 6 or more years significantly more frequently showed positive CRL than the controls and those receiving for less than 6 years did insignificantly. No constant trend was found between CRL and ulnar variance. As to hematologic parameter, serum Ca level greatly contributed to classification of CRL and tended to rise more when CRL was more serious whereas serum β2-microglobulin did not. From the above, it is Concluded that amyloidosis should be diagnosed in patients of Group 4 (having 3 or more radiolucent sites) treated for 6 or more years, in principle.