Kidney Involvement in Systemic Calcitonin Amyloidosis Associated With Medullary Thyroid Carcinoma

Timco Koopman*, Cindy Niedlich-den Herder, Coen A. Stegeman, Thera P. Links, Johan Bijzet, Bouke P. C. Hazenberg, Arjan Diepstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)

Abstract

A 52-year-old woman with widely disseminated medullary thyroid carcinoma developed nephrotic syndrome and slowly decreasing kidney function. A kidney biopsy was performed to differentiate between malignancy-associated membranous glomerulopathy and tyrosine kinase inhibitor-induced focal segmental glomerulosclerosis. Surprisingly, the biopsy specimen revealed diffuse glomerular deposition of amyloid that was proved to be derived from the calcitonin hormone (Acal), produced by the medullary thyroid carcinoma. This amyloid was also present in an abdominal fat pad biopsy. Although local ACal deposition is a characteristic feature of medullary thyroid carcinoma, the systemic amyloidosis involving the kidney that is presented in this case report has not to our knowledge been described previously and may be the result of long-term high plasma calcitonin levels. Our case illustrates that systemic calcitonin amyloidosis should be considered in the differential diagnosis of proteinuria in patients with medullary thyroid carcinoma.

Original languageEnglish
Pages (from-to)546-549
Number of pages4
JournalAmerican Journal of Kidney Diseases
Volume69
Issue number4
DOIs
Publication statusPublished - Apr-2017

Keywords

  • Calcitonin amyloid (ACal)
  • medullary thyroid carcinoma
  • systemic amyloidosis
  • kidney amyloidosis
  • amyloid-associated glomerulopathy
  • nephrotic syndrome
  • proteinuria
  • decreased kidney function
  • renal biopsy
  • case report
  • MASS-SPECTROMETRY
  • FIBRIL PROTEINS
  • AL AMYLOIDOSIS
  • DISEASES

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