Amiloidose Renal em Paciente Portadora de HIV: Relato de Caso/ Renal Amyloidosis in a Patient with HIV: Case Report
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Abstract
A lesão renal clássica do paciente portador de HIV é a glomeruloesclerose segmentar e focal colapsante; no entanto, aproximadamente 40% dos pacientes apresentam diagnóstico histológico diferencial, incluindo amiloidose renal. Amiloidose é um termo aplicado a um grupo heterogêneo de doenças raras, caracterizado pelo depósito extracelular de proteínas amilóides, causando disfunção de órgãos-alvo e uma ampla gama de sintomas clínicos. O trabalho tem como objetivo relatar e discutir o caso clínico de uma paciente portadora de HIV associado a amiloidose renal, que permanece com alteração na função renal, sendo submetida a sessões de hemodiálise três vezes por semana, além do acompanhamento periódico. Conclui-se que a amiloidose renal corresponde a aproximadamente 4% dos casos de nefropatia associado ao HIV, demonstrando a importância da biópsia renal para a confirmação do diagnóstico histológico da doença.
Palavras-chave: Amiloidose renal, Insuficiência renal, HIV
ABSTRACT
The classic renal lesion of patients with HIV is the focal segmental glomerulosclerosis collapsing, however, approximately 40% of patients have histologic differential diagnosis, including renal amyloidosis. Amyloidosis is a term applied to a heterogeneous group of rare disorders characterized by extracellular deposit of amyloid proteins, causing dysfunction of target organs and a broad range of clinical symptoms. The work aims to reportand discuss the clinical case of a patient with HIV-associated renal amyloidosis that remained with abnormal renal function, underwent arterial-venous fistula preparation with good patency and was maintained on hemodialysis sessions three times a week, in addition to outpatient regular monitoring. We conclude that renal amyloidosis accounts for approximately 4% of cases of HIV-associated nephropathy, demonstrating the importance of renal biopsy to confirm the histological diagnosis.
Keywords: Renal amyloidosis, Renal failure, HIV.
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