| Abstract: | Secondary amyloidosis is the leading cause of death in lepromatous leprosy in this country. The mortality is directly caused by amyloid involvement of the kidneys, which occurred in 100% of this series. The diagnosis of this complication depends largely on the development of a persistent proteinuria, Congo red absorption, hepatosplenomegaly and, to a lesser degree, altered serum proteins and perhaps liver biopsy in selected cases. the correlation between the Congo red test and the degree of amyloidosis is poor, and unless this test shows 80 to 100% dye absorption in one hour the diagnosis cannot be made from this finding alone. Serum protein and lipoid changes occur in lepromatous leprosy per se, and in a study of the various protein fractions no consistent alteration occurred in cases complicated by amyloidosis. The average duration of life after the onset of proteinuria in amyloidosis was 38.33 months, with a fairly wide range above and below this figure. The development of anemia and a progressive elevation of the nonprotein nitrogen are unfavorable prognostic signs.
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