Role of amyloid in dialysis-related arthropathies. A morphological analysis of 23 cases.

The role of beta 2-microglobulin-related amyloidosis in the articular syndromes associated with long-term haemodialysis was analysed in a series of 23 haemodialysed patients from whom 43 amyloid-containing osteoarticular specimens were obtained. Patients with clinical arthropathy had more intense and deep synovial involvement by amyloid than asymptomatic ones. Amyloid proved to be an agent for bone destruction, causing bone cysts and cortical erosions. Amyloid deposition in cartilage was found constantly, leading to fissures and irregularities in the articular surface. From our observations, amyloid seems to be the main pathogenetic factor involved in articular swelling, destructive arthropathies and pathological fractures occurring in haemodialysed patients, although other disturbances related to haemodialysis could play a role.