Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2019.128
Autopsy and Case Reports
Article / Autopsy Case Report

Chronic brucellosis with hepatic brucelloma and AA amyloidosis in a patient with autosomal dominant polycystic kidney disease

Arpitha Kollabathula; Vikarn Vishwajeet; Kirti Gupta; Suvradeep Mitra; Vibhav Sharma; Pallab Ray; Ashish Bhalla

Downloads: 0
Views: 382

Abstract

We describe an autopsy case of a 45-year-old male diagnosed with autosomal dominant polycystic kidney disease who presented with complaints of altered sensorium. The autopsy revealed multiple tumor-like masses in the liver, which on histological examination depicted multiple large suppurative granulomas with the presence of variable acid-fast coccobacilli (consistent with Brucella spp.). Interestingly, extensive amyloid deposition in multiple organs was noted. To the best of our knowledge, this is the first case of chronic brucellosis causing tumor-like abscesses in the liver accompanied by secondary systemic amyloidosis in a patient with underlying autosomal dominant polycystic kidney disease.

Keywords

Brucellosis, Amyloidosis, Autopsy, Polycystic Kidney, Autosomal Dominant

References

Gabow PA. Autosomal dominant polycystic kidney disease. N Engl J Med. 1993;329(5):332-42. [https://doi.org/10.1056/NEJM199307293290508]. [PMID:8321262]

Barutta L, Ferrigno D, Melchio R, et al. Hepatic brucelloma. Lancet Infect Dis. 2013;13(11):987-93. [https://doi.org/10.1016/S1473-3099(13)70197-X]. [PMID:24156899]

Joshi PA, Kulkarni RD, Powar RM. Modified cold ZN staining for presumptive identification of Brucella. Indian J Med Res. 2005;121(2):108-10. [PMID:15756043]

Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis. 2007;7(12):775-86. [https://doi.org/10.1016/S1473-3099(07)70286-4]. [PMID:18045560]

Davion T, Delamarre J, Sallebert S, Ducroix JP, Dusehu E, Capron JP. Hepatic brucelloma (pseudotumoral brucellar caseous necrosis of the liver). Study of a case and review of the literature. Gastroenterol Clin Biol. 1987;11(5):424-8. [PMID:3609638]

Cervantes F, Bruguera M, Carbonell J, Force L, Webb S. Liver disease in brucellosis. A clinical and pathological study of 40 cases. Postgrad Med J. 1982;58(680):346-50. [https://doi.org/10.1136/pgmj.58.680.346]. [PMID:7122367]

Young EJ, Hasanjani Roushan MR, Shafae S, Genta RM, Taylor SL. Liver histology of acute brucellosis caused by Brucella melitensis. Hum Pathol. 2014;45(10):2023-8. [https://doi.org/10.1016/j.humpath.2014.07.007]. [PMID:25147098]

Kamimura H, Tsuchiya K, Honda K, et al. Secondary systemic amyloidosis associated with frequently infected hepatic cysts in a patient with autosomal dominant polycystic kidney disease. Clin Nephrol. 2003;59(6):485-8. [https://doi.org/10.5414/CNP59485]. [PMID:12834186]

Sar F, Taylan I, Kutlu C, Caymaz MS, Tatli E, Kazancioglu R. Amyloidosis in a patient with autosomal dominant polycystic kidney disease and tuberculosis: a case report. Int Urol Nephrol. 2007;39(2):655-9. [https://doi.org/10.1007/s11255-006-9052-2]. [PMID:17318353]

Tsuchiya Y, Ubara Y, Suwabe T, et al. AA-amyloidosis in autosomal dominant polycystic kidney disease caused by chronic cyst infections lasting for 30 years. Intern Med. 2013;52(7):791-4. [https://doi.org/10.2169/internalmedicine.52.9277]. [PMID:23545677]

Yenigun EC, Dede F, Ozkayar N, et al. Coexistence of autosomal dominant polycystic kidney disease and amyloidosis in a patient with nephrotic-range proteinuria. Iran J Kidney Dis. 2014;8(3):243-5. [PMID:24878950]

Lachmann HJ, Goodman HJ, Gilbertson JA, et al. Natural history and outcome in systemic AA amyloidosis. N Engl J Med. 2007;356(23):2361-71. [https://doi.org/10.1056/NEJMoa070265]. [PMID:17554117]

Scarpioni R, Ricardi M, Albertazzi V, De Amicis S, Rastelli F, Zerbini L. Dialysis-related amyloidosis: challenges and solutions. Int J Nephrol Renovasc Dis. 2016;9:319-28. [https://doi.org/10.2147/IJNRD.S84784]. [PMID:27994478]

 

 

 


Publication date:
12/13/2019

5df3e2ce0e8825566e73a14d autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections