• Yasuhiro Oda, Kunihiro Ishioka, Takayasu Ohtake, Rikako Oki, Shinya Taguchi, Kenji Matsui, Yasuhiro Mochida, Hidekazu Moriya, Sumi Hidaka, and Shuzo Kobayashi.
• Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital, Japan.
• Intern. Med. 2023 Dec 15; 62 (24): 366936773669-3677.

AbstractA 74-year-old woman with a 34-year history of hemodialysis presented with an intermittent fever, which later coincided with recurrent bilateral shoulder and hip joint pain. Imaging studies suggested amyloid arthropathy, which was histologically confirmed by a synovial biopsy. Increasing β2-microglobulin clearance during dialysis alone attenuated the intermittent fever and joint pain, but the symptoms did not disappear until the administration of prednisolone 10 mg/day. Reported cases of dialysis-related amyloidosis with a fever imply that changing to blood purification methods with high β2-microglobulin clearance is crucial for controlling the condition long-term, whereas concurrent use of anti-inflammatory agents promptly alleviates the symptoms.

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