Pseudomonas-driven amyloid storm: a tale of two cases with rapidly progressive kidney injury

Abstract

AA amyloidosis is a significant cause of chronic kidney disease and, if untreated, often leads to progressive kidney damage. This study aims to illustrate how AA amyloidosis can manifest as both slowly progressing chronic kidney injury and rapidly progressive acute kidney injury triggered by secondary conditions.

We describe two patients experiencing an amyloid storm related to Pseudomonas aeruginosa infection: one with bronchiectasis-related amyloidosis and another with paraplegia and decubitus ulcer-related amyloidosis. Clinical, laboratory, and kidney biopsy findings were analyzed.

Both cases demonstrated accelerated kidney failure within two weeks. The first case involved chronic decubitus ulcers and osteomyelitis, while the second had bronchiectasis with pneumonia. Despite infection control and colchicine therapy, both patients experienced irreversible renal damage.

These cases underscore the importance of aggressive infection control in preventing amyloid storm and highlight the interplay between chronic inflammation and acute infections in AA amyloidosis.