Endocrine pathology in spinal cord injured patients on maintenance dialysis

We studied the histopathological changes of the thyroid, adrenal and parathyroid glands, testes and pancreata in 15 patients with end-stage renal disease associated with long-standing spinal cord injury. All patients were males aged 42.7 +/- 9.4 years and were treated with maintenance haemodialysis for 20.4 +/- 17.7 months. Thyroid amyloidosis was present in eight of 12 glands and was extensive in four and moderate in four. Thyromegaly was noted in five of the glands with amyloid involvement. Of the 30 available adrenal glands, 26 showed amyloid involvement which was extensive in ten and moderate in 16. Of 18 testes examined all exhibited marked atrophy, decreased or absent spermatogenesis and marked peritubular and interstitial fibrosis. Amyloid involvement was also noted in two subjects. Pancreata were examined in 15 subjects with amyloidosis and pancreatitis noted in eight and four glands, respectively. Of the 22 parathyroid glands examined in nine subjects, hyperplasia was noted in 13 glands (four patients) and moderate amyloidosis was noted in six glands (two patients). Our results demonstrate a high prevalence of endocrine organ pathology in dialysis patients with longstanding spinal cord injury. Functional significance of these pathological findings is unclear and requires further investigation.