長期透析患者の両側顎関節アミロイドーシスの1例

  • 鷲見 幸男
    名古屋第二赤十字病院・歯科口腔外科
  • 林 康司
    名古屋第二赤十字病院・歯科口腔外科
  • 服部 浩朋
    名古屋第二赤十字病院・歯科口腔外科
  • 宇佐見 一公
    名古屋第二赤十字病院・歯科口腔外科
  • 水野 裕和
    名古屋大学大学院医学研究科頭頸部感覚器外科学講座顎顔面外科学
  • 上田 実
    名古屋大学大学院医学研究科頭頸部感覚器外科学講座顎顔面外科学

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  • A case of bilateral amyloidosis of the temporomandibular joint associated with long-term hemodialysis

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Dialysis-related amyloidosis (DRA) is a serious complication occuring most often in patients undergoing long-term hemodialysis (LHD) and in patients receiving renal replacement therapy. The deposition of amyloid, which consists of beta 2 -microgloblin that is not removed by normal hemodialysis, is a major contributing factor to DRA. We describe a case of bilateral amyloidosis of the temporomandibular joint (TMJ) that developed after LHD therapy. A 68-year-old man was referred by the transplant surgery department of our hospital to our outpatient clinic for detailed examination of a left preauricular swelling.<BR>The first examination showed swelling of the left preauricular soft tissue. The swelling was about 3cm in a diameter and 1cm in height, nontender, and firmer than other intact areas of facial skin. In the right preauricular soft tissue, we palpated a nontender, round subcutaneous lesion about 2.5cm in diameter. Magnetic resonance imaging suggested amyloidosis. An excisional biopsy of the left TMJ was performed, revealing DRA of the TMJ. DRA of the tongue, lip, and buccal mucosa have been often reported, but DRA of the TMJ has not been previously reported in Japan or abroad in the oral and maxillofacial field. There is no treatment available for this condition. The patient is being followed up periodically, and there has been no change in his condition.

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