Related Experiment Video

Updated: Dec 18, 2025

Refined Murine Model of Idiopathic Pulmonary Fibrosis

Refined Murine Model of Idiopathic Pulmonary Fibrosis

Published on: June 17, 2025

Secondary renal amyloidosis associated with asbestos-related pleuropulmonary diseases

Ryoko Shibata¹, Tomomi Ozaki¹, Kazuhiro Tada¹

¹Division of Nephrology and Rheumatology, Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan.

CEN Case Reports

|June 15, 2020

Abstract:

Here, we present a 67-year-old Japanese man who developed insidious-onset nephrotic syndrome. He had a history of occupational asbestos exposure for about 8 years during his 30s, and was found to have pleural effusion 3 years before his present illness. At that time, repeated cytology testing of his pleural effusion found no malignant cells, and pleural biopsy found fibrous pleuritis without evidence of malignant mesothelioma. Percutaneous kidney biopsy found massive deposits of AA-type amyloid in the glomeruli, small arteries, and medulla. Computed tomography showed a calcified mass in the right lower lung that was positive for ⁶⁷Ga uptake, but transbronchial lung biopsy and bronchoalveolar lavage found no evidence of malignancy. He was diagnosed with rounded atelectasis and diffuse pleural thickening. As these benign asbestos-related diseases have no standard treatment, we administered low-dose angiotensin II receptor blocker to preserve kidney function. Unfortunately, his nephrotic syndrome persists, with progressive chronic kidney failure. Kidney involvement in patients with asbestos-related disease is rare. To our knowledge, this is the first case to present with secondary amyloidosis. Kidney biopsy should be considered for patients with existing asbestos-related pleuropulmonary diseases who have urinary abnormalities or renal dysfunction, to clarify the incidence and pathophysiology of renal manifestations.

Insights

This case study details a man with asbestos exposure who developed nephrotic syndrome due to AA-type amyloidosis, a rare kidney complication. Early kidney biopsy is recommended for asbestos-exposed individuals with renal issues.

Area of Science:

Nephrology
Pulmonology
Pathology

Background:

Asbestos exposure is linked to various pleuropulmonary diseases.
Nephrotic syndrome is a kidney disorder characterized by heavy protein loss in urine.
Secondary amyloidosis involves amyloid protein deposition in organs, often triggered by chronic inflammation.

Observation:

A 67-year-old man with a history of significant asbestos exposure presented with insidious-onset nephrotic syndrome.
Kidney biopsy revealed extensive AA-type amyloid deposits in the glomeruli, small arteries, and medulla.
Lung imaging showed a calcified mass, but biopsies confirmed benign asbestos-related conditions like fibrous pleuritis and rounded atelectasis.

Findings:

The patient was diagnosed with AA-type amyloidosis secondary to asbestos-related disease, leading to persistent nephrotic syndrome and progressive chronic kidney failure.
This represents the first reported case of secondary amyloidosis presenting as nephrotic syndrome in a patient with asbestos-related pleuropulmonary disease.
Despite treatment with an angiotensin II receptor blocker, renal function continued to decline.

Implications:

Kidney involvement in asbestos-related diseases, particularly secondary amyloidosis, is rare but significant.
Kidney biopsy is crucial for diagnosing renal manifestations in patients with asbestos exposure and urinary abnormalities or renal dysfunction.
Further research is needed to understand the incidence and pathophysiology of renal involvement in asbestos-related conditions.

Read full analysis

Keywords:

AA amyloid Kidney biopsy Latent period Malignant mesothelioma Nephrotic syndrome

More Related Videos

Author Spotlight: Exploring the Role of Inflammation in the Co-occurrence of Primary Sjogren's Syndrome and Lung Adenocarcinoma

Author Spotlight: Exploring the Role of Inflammation in the Co-occurrence of Primary Sjogren's Syndrome and Lung Adenocarcinoma

Published on: September 20, 2024

Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice

Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice

Published on: December 21, 2019

Related Concept Videos

Other Pulmonary Disorders

Other Pulmonary Disorders

Respiratory disorders encompass a range of conditions with varying levels of severity. Asthma, marked by chronic airway inflammation and hypersensitivity, is one such condition. It can lead to airway obstruction due to factors like bronchial spasms, mucosal edema, increased mucus secretion, or epithelial damage. Asthma triggers are diverse, ranging from allergens to emotional upset, and treatment focuses on both immediate relief through bronchodilators and long-term inflammation suppression.

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome I : Introduction

Nephrotic Syndrome is a chronic kidney disorder defined by clinical findings such as severe proteinuria, hypoalbuminemia, hyperlipidemia, and edema. These symptoms result from damage to the glomeruli, the kidney’s filtering units, increasing their permeability to proteins.Definition and Meaning:Proteinuria, defined as the loss of more than 3.5 grams of protein per day in adults, is a crucial feature of nephrotic syndrome. This condition is often accompanied by edema, the accumulation of...

Amyloid Fibrils

Amyloid Fibrils

Amyloid fibrils are aggregates of misfolded proteins. Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils.
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...

Pulmonary Tuberculosis III

Pulmonary Tuberculosis III

Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:

Pulmonary Tuberculosis II

Pulmonary Tuberculosis II

Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...

Chronic Obstructive Pulmonary Disease-II: Pathophysiology

Chronic Obstructive Pulmonary Disease-II: Pathophysiology

Chronic Obstructive Pulmonary Disease (COPD) pathophysiology is intricate and multifaceted, involving a complex interplay of physiological processes. Understanding these mechanisms is crucial for effectively managing and treating COPD. Here is an in-depth look at the critical elements in the pathophysiology of COPD:
Chronic Inflammation

Articles linked to this work by shared authors, journal, and citation graph.

Association Between the Implementation of Shared Decision-Making and Clinical Characteristics of Living-Donor Kidney Transplantation.

Healthcare (Basel, Switzerland)·2026

The Waist-to-Height Ratio and Incidence of High LDL Cholesterol in Japanese: A Retrospective Cohort Study.

Journal of atherosclerosis and thrombosis·2026

Pre-admission Barthel Index and serum albumin are associated with discharge to the pre-admission residence after percutaneous transhepatic gallbladder drainage for acute cholecystitis.

Surgery today·2026

Accelerated use of artificial intelligence-associated vocabulary in Japanese surgical journals after 2023.

Surgery today·2026

Pharmacokinetic and pharmacogenomic profile of capecitabine and oxaliplatin in a patient with gastric cancer undergoing hemodialysis: a case report.

Cancer chemotherapy and pharmacology·2026

Serum pentosidine levels are associated with reduced eGFR, including in individuals with preserved renal function: a cross-sectional analysis from the Fukuoka Epidemiological Study of Atherosclerosis.

BMC nephrology·2026

See all related articles