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

DOI 2 Citations 15 References
  • SUMI Yukio
    Dentistry and Oral & maxillofacial Surgery, Nagoya Daini Red Cross Hospital
  • HAYASHI Yasushi
    Dentistry and Oral & maxillofacial Surgery, Nagoya Daini Red Cross Hospital
  • HATTORI Hirotomo
    Dentistry and Oral & maxillofacial Surgery, Nagoya Daini Red Cross Hospital
  • USAMI Kazutada
    Dentistry and Oral & maxillofacial Surgery, Nagoya Daini Red Cross Hospital
  • MIZUNO Hirokazu
    Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine
  • UEDA Minoru
    Department of Oral and Maxillofacial Surgery, Nagoya University Graduate School of Medicine

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  • 長期透析患者の両側顎関節アミロイドーシスの１例

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Abstract

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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