Medica Jadertina, Vol. 40 No. 3-4, 2010.
Stručni rad
Amyloidosis related carpal tunel syndrome in patients with chronic renal disease: case report
Damir Matoković
; Opća županijska bolnica Požega, Odjel ortopedije
Miroslav Hašpl
; Specijalna bolnica za ortopediju i traumatologiju, "Akromion", Krapinske Toplice
Joško Smilović
; Opća županijska bolnica Čakovec, Odjel ortopedije
Petar Petrić
; Opća županijska bolnica Požega, Odjel za hemodijalizu
Sanja Škorvaga
; Opća županijska bolnica Požega, Odjel za laboratorijsku dijagnostiku
Sažetak
Patients with CRF (chronic renal failure) have elevated AGE (advanced glycation end products). AGE are formed during glycation and oxidative stress, and accumulation of AGE occurs especially in CRF and plays a major pathogenic role. Amyloidosis is a common complication in patients with chronic renal failure.
Amyloidosis develops due to impossible β2-microglobulin excretion. The number of patients with histologically demonstrable amyloidosis increases with the length of hemodialysis. Histologic signs of amyloidosis are found in one third and 90% of patients undergoing hemodialysis for up to 4 years and 5-7 years, respectively. Histologic signs alone are present initially, whereas clinical signs develop later. The carpal tunnel syndrome is one of the first clinical signs of amyloidosis. The syndrome develops in one third of patients undergoing hemodialysis for 5-10 years and nearly 100% of those treated by hemodialysis for 20 years. The carpal tunnel syndrome is not a fatal disease; however, if left untreated, it leads to median nerve lesion and atrophy of the hand musculature with severe functional deficits. The patient presented was operatively treated, followed by rehabilitation that resulted in satisfactory functional and anatomical outcome. Accordingly, timely diagnosis and median nerve decompression are the main preconditions for successful management of the carpal tunnel syndrome. In contrast to “low-flux” hemodialyzers, the new ”high-flux” devices offer appropriate biocompatibility and β2-microglobulin removal, thus a lower rate of
complications such as carpal tunnel syndrome due to amyloidosis is expected in patients with chronic renal failure.
Ključne riječi
carpal tunnel syndrome; amyloidosis; hemodialysis
Hrčak ID:
65154
URI
Datum izdavanja:
1.3.2011.
Posjeta: 2.829 *