SHM Converge Scientific Abstract ePoster Gallery-Sweating It Out: Aa Amyloidosis Secondary to Chronic Hidradenitis Suppurativa in a 50-Year-Old Male Presenting With Renal Dysfunction

Sweating It Out: Aa Amyloidosis Secondary to Chronic Hidradenitis Suppurativa in a 50-Year-Old Male Presenting With Renal Dysfunction

Back to course

Pdf Summary

This case describes a 50-year-old man with chronic hidradenitis suppurativa (HS) who was sent for evaluation after abnormal outpatient labs showed renal dysfunction, anemia, leukocytosis, and a marked protein gap. He had rising creatinine and heavy proteinuria, raising concern for kidney involvement. Extensive serologic testing for infectious and glomerular causes was negative, and renal ultrasound showed enlarged, echogenic kidneys consistent with chronic disease.<br /><br />A renal biopsy revealed nodular amorphous deposits in glomeruli and blood vessel walls. Congo red staining showed apple-green birefringence, confirming amyloid deposition. Because immunofixation did not show light chain restriction, AL amyloidosis was unlikely. The findings supported AA amyloidosis, a complication of chronic inflammatory disease caused by deposition of serum amyloid A–derived fibrils.<br /><br />The case highlights that AA amyloidosis can develop in patients with longstanding inflammatory conditions such as HS and may present subtly with proteinuria, anemia, and worsening kidney function. Diagnosis is often challenging because symptoms are variable and nonspecific. In this patient, the renal findings strongly suggested amyloidosis, and treatment focused on managing the underlying inflammation. He was started on lisinopril and referred to dermatology for immunomodulator therapy to control HS and reduce ongoing amyloid deposition risk.<br /><br />Key takeaways are that HS is a systemic inflammatory disease that can cause uncommon internal complications, AA amyloidosis should be considered in HS patients with renal dysfunction, and early recognition is important to preserve kidney function and prevent further end-organ damage. Multidisciplinary follow-up is essential.

Asset Subtitle

Gaelan Montoya

Meta Tag

Author List Andrew M. Cyr, Gaelan Montoya, Jared S. Honigman Do, Lani Teytelman, Nerihan Hadji

Category Clinical Vignettes

Concept AL Amyloidosis

Concept Kidney Biopsy

Concept Underlying Inflammatory Disease Control

Concept Inflammatory Disease

Concept Proteinuria

Distinguished Non-Finalist

Presenter Organization Zucker School of Medicine at Hofstra/ Northwell, Northshore University Hospital

Presenting Author Gaelan Montoya

Track Adult

Keywords

hidradenitis suppurativa

AA amyloidosis

renal dysfunction

proteinuria

kidney biopsy

Congo red staining

serum amyloid A

chronic inflammation

glomerular deposits

multidisciplinary management

AL Amyloidosis

Kidney Biopsy

Underlying Inflammatory Disease Control

Inflammatory Disease

Proteinuria