Renal amyloidosis complicating bladder carcinoma associated with supra renal insufficiency

A 61-year-old white man was admitted for evaluation of hematuria. His medical history revealed endoscopic resection of bladder carcinoma 10 years earlier. A diagnosis of relapse of this carcinoma was made. Few months later, he developed low blood pressure and the nephrotic syndrome. Examination of a renal biopsy specimen showed amyloid deposits. Results of immunofluorescence were positive for AA protein. Furthermore, laboratory tests demonstrated suprarenal insufficiency probably due to amyloidosis. A diagnosis of bladder carcinoma- induced amyloidosis of the kidneys and suprarenal glands was made since no other identifiable cause for AA amyloidosis was found.