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Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

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Abstract

Nine patients undergoing regular dialytic treatment for more than 60 months showed clinical and radiologic features of a noninfective and destructive spondyloarthropathy. The cervical spine was most affected (100%), followed by the dorsal (three patients, 33.3%) and the lumbar spine (two patients, 22.2%). Typically, radiographs and CT scans revealed narrowing of intervertebral spaces, with destruction or sclerosis of the subchondral bone of the vertebral plate.

Autopsy was performed on three patients; histologic study demonstrated the presence of large amyloid deposits containing β 2-microglobulin (β 2-m) in the discs and peridiscal ligaments.

A radiographic follow-up of the cervical spine was performed in seven patients after a period of 12 months and showed that the bone destruction in DSA is very rapid and progressive. The lower biocompatibility of the cuprophan membranes of dialyzers is probably the factor most responsible for hyperproduction of β 2-m and subsequently osteoarticular deposition of a new type of amyloidosis.

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Authors and Affiliations

  1. Department of Radiology, S. Anna Hospital, Italy

    Carlo Orzincolo M.D. & Piero Cardona M.D.

  2. Department of Nephrology, S. Anna Hospital, Italy

    Pier Luigi Bedani M.D. & Paolo Gilli M.D.

  3. Department of Rheumatology, S. Anna Hospital, Italy

    Pier Nuccio Scutellari M.D.

  4. Institute of Radiology, University School of Medicine, Ferrara, Italy

    Francesco Trotta M.D.

Authors
  1. Carlo Orzincolo M.D.
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  2. Pier Luigi Bedani M.D.
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  3. Pier Nuccio Scutellari M.D.
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  4. Piero Cardona M.D.
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  5. Francesco Trotta M.D.
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  6. Paolo Gilli M.D.
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Orzincolo, C., Bedani, P.L., Scutellari, P.N. et al. Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients. Skeletal Radiol. 19, 483–487 (1990). https://doi.org/10.1007/BF00202694

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