Skip to main content
The American Journal of Pathology logoLink to The American Journal of Pathology
. 1983 Aug;112(2):195–199.

AA protein-related renal amyloidosis in drug addicts.

S Menchel, D Cohen, E Gross, B Frangione, G Gallo
PMCID: PMC1916266  PMID: 6881286

Abstract

Reports of renal amyloidosis occurring among narcotic addicts have been limited, for the most part, to case reports. In a prospective survey of 150 addicts examined at autopsy in the Office of the Chief Medical Examiner of the City of New York, 7 cases of renal amyloidosis were found. Immunohistologic examination demonstrated that in all of the 7 cases, the amyloid was AA protein-related. The amyloid extracted from the kidneys of two addicts and analyzed biochemically did not differ from the AA amyloid secondary to chronic infectious and inflammatory diseases. The combined data of previous reports and the present survey demonstrate that addicts who are subcutaneous users with skin infections most frequently develop amyloidosis. Our data demonstrating renal amyloidosis in 26% of addicts with chronic suppurative skin infections suggest that such addicts are at high risk for the development of amyloidosis.

Full text

PDF
195

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brownstein M. H., Helwig E. B. Systemic amyloidosis complicating dermatoses. Arch Dermatol. 1970 Jul;102(1):1–7. [PubMed] [Google Scholar]
  2. Brus I., Steiner G., Maceda A., Lejano R. Amyloid fibrils in urinary sediment. Heroin addiction with renal amyloidosis. N Y State J Med. 1979 Apr;79(5):768–771. [PubMed] [Google Scholar]
  3. Cherubin C. E. Infectious disease problems of narcotic addicts. Arch Intern Med. 1971 Aug;128(2):309–313. doi: 10.1001/archinte.1971.00310200145021. [DOI] [PubMed] [Google Scholar]
  4. Cunningham E. E., Brentjens J. R., Zielezny M. A., Andres G. A., Venuto R. C. Heroin nephropathy. A clinicopathologic and epidemiologic study. Am J Med. 1980 Jan;68(1):47–53. doi: 10.1016/0002-9343(80)90164-3. [DOI] [PubMed] [Google Scholar]
  5. DALTON J. J., Jr, HACKLER R. H., BUNTS R. C. AMYLOIDOSIS IN THE PARAPLEGIC; INCIDENCE AND SIGNIFICANCE. J Urol. 1965 May;93:553–555. doi: 10.1016/S0022-5347(17)63826-6. [DOI] [PubMed] [Google Scholar]
  6. Dikman S. H., Kahn T., Gribetz D., Churg J. Resolution of renal amyloidosis. Am J Med. 1977 Sep;63(3):430–433. doi: 10.1016/0002-9343(77)90281-9. [DOI] [PubMed] [Google Scholar]
  7. Frangione B., Rosenwasser E., Prelli F., Franklin E. C. Primary structure of human gamma 3 immunoglobulin deletion mutant: gamma 3 heavy-chain disease protein Wis. Biochemistry. 1980 Sep 2;19(18):4304–4308. doi: 10.1021/bi00559a024. [DOI] [PubMed] [Google Scholar]
  8. Grishman E., Churg J., Porush J. G. Glomerular morphology in nephrotic heroin addicts. Lab Invest. 1976 Nov;35(5):415–424. [PubMed] [Google Scholar]
  9. HOFFMAN S., SIMON B. E., FISCHEL R. A., GRIBETZ D. RENAL AMYLOIDOSIS RESULTING FROM A CHRONICALLY INFECTED BURN. Pediatrics. 1963 Nov;32:888–894. [PubMed] [Google Scholar]
  10. Helpern M., Rho Y. M. Deaths from narcotism in New York City. Incidence, circumstances, and postmortem findings. N Y State J Med. 1966 Sep 15;66(18):2391–2408. [PubMed] [Google Scholar]
  11. Holzman R. S., Bishko F. Osteomyelitis in heroin addicts. Ann Intern Med. 1971 Nov;75(5):693–696. doi: 10.7326/0003-4819-75-5-693. [DOI] [PubMed] [Google Scholar]
  12. Jacob H., Charytan C., Rascoff J. H., Golden R., Janis R. Amyloidosis secondary to drug abuse and chronic skin suppuration. Arch Intern Med. 1978 Jul;138(7):1150–1151. [PubMed] [Google Scholar]
  13. Kilcoyne M. M., Gocke D. J., Meltzer J. I., Daly J. J., Thomson G. E., Hsu K. C., Tannenbaum M. Nephrotic syndrome in heroin addicts. Lancet. 1972 Jan 1;1(7740):17–20. doi: 10.1016/s0140-6736(72)90007-4. [DOI] [PubMed] [Google Scholar]
  14. Levin M., Franklin E. C., Frangione B., Pras M. The amino acid sequence of a major nonimmunoglobulin component of some amyloid fibrils. J Clin Invest. 1972 Oct;51(10):2773–2776. doi: 10.1172/JCI107098. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Louria D. B., Hensle T., Rose J. The major medical complications of heroin addiction. Ann Intern Med. 1967 Jul;67(1):1–22. doi: 10.7326/0003-4819-67-1-1. [DOI] [PubMed] [Google Scholar]
  16. Lowenstein J., Gallo G. Remission of the nephrotic syndrome in renal amyloidosis. N Engl J Med. 1970 Jan 15;282(3):128–132. doi: 10.1056/NEJM197001152820304. [DOI] [PubMed] [Google Scholar]
  17. Meador K. H., Sharon Z., Lewis E. J. Renal amyloidosis and subcutaneous drug abuse. Ann Intern Med. 1979 Oct;91(4):565–567. doi: 10.7326/0003-4819-91-4-565. [DOI] [PubMed] [Google Scholar]
  18. Novick D. M., Yancovitz S. R., Weinberg P. G. Amyloidosis in parenteral drug abusers. Mt Sinai J Med. 1979 Mar-Apr;46(2):163–167. [PubMed] [Google Scholar]
  19. Pras M., Schubert M., Zucker-Franklin D., Rimon A., Franklin E. C. The characterization of soluble amyloid prepared in water. J Clin Invest. 1968 Apr;47(4):924–933. doi: 10.1172/JCI105784. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Rao T. K., Nicastri A. D., Friedman E. A. Natural history of heroin-associated nephropathy. N Engl J Med. 1974 Jan 3;290(1):19–23. doi: 10.1056/NEJM197401032900105. [DOI] [PubMed] [Google Scholar]
  21. Rho Y. M. Infections as fatal complications of narcotism. N Y State J Med. 1972 Apr 1;72(7):823–830. [PubMed] [Google Scholar]
  22. Rosenthal C. J., Franklin E. C. Variation with age and disease of an amyloid A protein-related serum component. J Clin Invest. 1975 Apr;55(4):746–753. doi: 10.1172/JCI107985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sapira J. D., Ball J. C., Penn H. Causes of death among institutionalized narcotic addicts. J Chronic Dis. 1970 Apr;22(11):733–742. doi: 10.1016/0021-9681(70)90049-4. [DOI] [PubMed] [Google Scholar]
  24. Scholes J., Derosena R., Appel G. B., Jao W., Boyd M. T., Pirani C. L. Amyloidosis in chronic heroin addicts with the nephrotic syndrome. Ann Intern Med. 1979 Jul;91(1):26–29. doi: 10.7326/0003-4819-91-1-26. [DOI] [PubMed] [Google Scholar]
  25. Shapiro A. L., Viñuela E., Maizel J. V., Jr Molecular weight estimation of polypeptide chains by electrophoresis in SDS-polyacrylamide gels. Biochem Biophys Res Commun. 1967 Sep 7;28(5):815–820. doi: 10.1016/0006-291x(67)90391-9. [DOI] [PubMed] [Google Scholar]
  26. Treser G., Cherubin C., Longergan E. T., Yoshizawa N., Viswanathan V., Tannenberg A. M., Pompa D., Lange K. Renal lesions in narcotic addicts. Am J Med. 1974 Nov;57(5):687–694. doi: 10.1016/0002-9343(74)90842-0. [DOI] [PubMed] [Google Scholar]
  27. Triger D. R., Joekes A. M. Renal amyloidosis--a fourteen-year follow-up. Q J Med. 1973 Jan;42(165):15–40. [PubMed] [Google Scholar]
  28. White A. G. Medical disorders in drug addicts. 200 consecutive admissions. JAMA. 1973 Mar 26;223(13):1469–1471. [PubMed] [Google Scholar]

Articles from The American Journal of Pathology are provided here courtesy of American Society for Investigative Pathology

RESOURCES