Dialysis-related amyloidosis

Dialysis-related amyloidosisA 71-year-old woman with long-standing systemic hypertension developed progressive worsening renal function and she was initiated on haemodialysis 10 years back.In the past 4 years, she has bilateral shoulder pain with restriction of movements and presently came to us with worsening pain.On examination, there was warmth, tenderness, swelling and restriction of movements of the shoulder.She underwent magnetic resonance imaging of her shoulders, which showed features suggestive of amyloidosis (Figure 1A andB).She underwent arthroscopic synovectomy of shoulder joints, which was consistent with amyloidosis (Figure 1C).Dialysis-related amyloidosis is characterized by the tissue deposition of beta2-microglobulin amyloid particularly in joints, blood vessels and the gastrointestinal tract.