Keyword: renal biopsy

ABSTRACT: Familial Mediterranean Fever (FMF) is an autosomal recessive autoinflammatory disorder caused by mutations in the MEFV gene. It is most common among populations from the Eastern Mediterranean region, including Turks, Armenians, Arabs, and Sephardic Jews. One of the most serious complications of FMF is AA amyloidosis, which develops as a result of chronic inflammation and the deposition of serum amyloid A protein. AA amyloidosis frequently affects the kidneys, leading to nephrotic syndrome and chronic kidney disease.
We report a case of a 17-year-old Turkish male presenting with recurrent episodes of fever, joint pain, periodic skin rashes, and intermittent hypertension. Laboratory evaluation revealed nephrotic-range proteinuria, hypoalbuminemia, low serum IgG, and elevated inflammatory markers. Renal biopsy confirmed AA amyloidosis with moderate interstitial lymphocytic infiltration and mild fibrosis. Genetic testing identified a homozygous pathogenic variant in exon 10 of the MEFV gene (p.Met694Val), previously reported and strongly associated with FMF.
This case highlights the rarity of such presentations and emphasizes the importance of early diagnosis of FMF complicated by AA amyloidosis. The patient remains on colchicine therapy with careful monitoring for potential complications; corticosteroids were gradually tapered following confirmation of amyloidosis, with supportive and symptomatic management continued.
 

ABSTRACT: A 41-year old female patient who underwent kidney transplantation as an outcome of chronic glomerulonephritis came to the hospital with the signs of acute upper respiratory tract infection. As the patient further developed oliguria, peripheral edema, fever, and an increased BP, she was further relocated to the University Medical Center (UMC). Upon admission to UMC, signs of septic shock were detected, and acute transplant rejection was suspected, to exclude which kidney biopsy was performed and stage 3 chronic kidney disease (CKD) in allograft kidney was detected. Antibacterial treatment as well as pulse therapy were performed as patient had septic shock and tubulointerstitial nephritis (TIN).