A 61-year-old Chinese woman has been diagnosed with an exceptionally rare combination of ALECT2 amyloidosis and IgA nephropathy, challenging current understanding of renal disease manifestations. Her case underscores the complexities involved in diagnosing concurrent kidney conditions that present with overlapping symptoms.
Complex Diagnostic Process Unveils Dual Kidney Conditions
The patient initially presented with symmetrical lower limb edema and microscopic hematuria, without the presence of nephrotic syndrome or significant proteinuria. A comprehensive renal biopsy was conducted, revealing diffuse interstitial amyloid deposits alongside signs of IgA nephropathy. To confirm the specific type of amyloidosis, laser microdissection combined with mass spectrometry (LMD/MS) was employed, successfully identifying the LECT2 amyloid protein. This meticulous diagnostic approach was pivotal in accurately identifying the dual nature of her kidney disease.
Effective Treatment Stabilizes Renal Function
Following the diagnosis, the patient received treatment with sodium-glucose transport protein 2 (SGLT-2) inhibitors. Over a six-month follow-up period, her renal function remained stable, indicating a positive response to the treatment regimen. This outcome highlights the potential effectiveness of SGLT-2 inhibitors in managing complex cases involving multiple kidney disorders.
- Co-occurrence of ALECT2 amyloidosis and IgA nephropathy may be underdiagnosed due to overlapping symptoms.
- Advanced diagnostic techniques like LMD/MS are crucial for accurate identification of rare renal conditions.
- SGLT-2 inhibitors may offer an effective treatment option for patients with dual kidney disease.
This case emphasizes the necessity for healthcare professionals to consider the possibility of multiple concurrent renal disorders, especially in patients presenting with atypical symptoms. Utilizing a combination of immunological techniques and advanced mass spectrometry methods can enhance diagnostic accuracy, ensuring timely and appropriate treatment. Furthermore, the successful stabilization of renal function through SGLT-2 inhibitors suggests that these medications could play a significant role in the therapeutic strategy for similar complex kidney disease cases. Ongoing research and case studies are essential to better understand the interplay between different forms of amyloidosis and other nephropathies, ultimately improving patient outcomes through tailored medical interventions.
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