Longest Survival with Renal AA Amyloidosis: Development of End Stage Renal Disease after 25 Years of AA Amyloidosis Diagnosis

This is case report of a patient who was diagnosed with secondary AA Amyloidosis of the kidneys due to Pulmonary Tuberculosis in 1973. AA Amyloidosis was diagnosed based on renal biopsy due to heavy proteinuria. Nephrotic Syndrome and concomitant renal insufficiency resolved after treatment of tuberculosis. Patient remained proteinuria free with preservation of renal function for more than 25 years. He presented to the same hospital 25 years later with heavy proteinuria and advanced renal failure. The work up of renal failure was inconclusive during this admission. He underwent a repeat diagnostic renal biopsy which revealed AA Amyloidosis present throughout the kidney. Rectal and minor Salivary gland biopsies also revealed AA amyloidosis. The patient was started on chronic renal replacement therapy but unfortunately expired after few months due to bacteremia.