A 46-year-old woman with severe rheumatoid arthritis presents with progressive bilateral lower extremity edema and heavy proteinuria (4.2 g/day). Vital signs show BP 142/88 mmHg, HR 88/min, RR 16/min, temp 37.2°C. Serum creatinine is 1.8 mg/dL. Renal biopsy demonstrates Congo red positive, birefringent deposits in the glomerular mesangium and vessel walls. Urinalysis shows no hematuria. Which protein is the most likely precursor of these deposits?
- A)Mutant transthyretin
- B)Immunoglobulin light chains
- C)Beta 2 microglobulin
- D)Islet amyloid polypeptide
- E)Serum amyloid AGABARITO
Explicação
AA amyloidosis is derived from serum amyloid A, an acute phase reactant produced by the liver during chronic inflammation. Long standing inflammatory diseases such as rheumatoid arthritis can cause systemic AA amyloid deposition, especially in the kidneys. Ver explicação completa e trilha adaptativa →