ESPN 50th Annual Meeting

ESPN 2017


 
Renal amyloidosis is still a health problem in Armenia – effect of colchicine
HELEN NAZARYAN 1 ARMEN SANAMYAN 1 GAYANE AMARYAN 3 SOFI SARINYAN 1 MARINA PAPAZYAN 1 ERNST LEUMANN 4 ASHOT SARKISSIAN 2

1- “ARABKIR” MEDICAL CENTRE; YEREVAN, ARMENIA
2- YEREVAN STATE MEDICAL UNIVERSITY, YEREVAN, ARMENIA
3- NATIONAL PEDIATRIC CENTER FOR FMF, YEREVAN, ARMENIA
4- UNIVERSITY CHILDREN’S HOSPITAL, ZURICH, SWITZERLAND
 
Introduction:

Familial Mediterranean fever (FMF) is a serious health problem in Armenian children. Although amyloidosis – a potentially fatal complication of FMF – can largely be prevented by colchicine administration, we are still confronted with renal amyloidosis. The aim was to analyse the demography and reasons for amyloid nephropathy in pediatric patients and the late effects of colchicine.

Material and methods:

The National Pediatric Center for FMF (NPC FMF) was established in 1998 to allow early diagnosis, treatment, follow-up and wide dissemination of information on FMF. Since 2003 NPC FMF has provided colchicine at no charge to over 3000 children below the age of 18 years. Diagnosis of FMF is based on Tel-Hashomer criteria and molecular genetic analysis (since 1998). Amyloid nephropathy was confirmed by renal biopsy (Congo Red). All pediatric renal biopsies since 1993 (n= 307) are included. The data 1993 - 2004 (group 1; n=155) and 2005 – 2016 (group 2; n=152) have been analyzed separately. Colchicine was administered to all patients with renal amyloidosis.

Results:

Amyloid nephropathy was diagnosed in 38 pts (24.5%) in group 1 and in 22 (14.5%) in group 2 (p < 0.05). In the second group diagnosis of FMF had been missed in 18 patients, one was noncompliant and in three colchicine was not sufficiently effective. On admission six had proteinuria, 14 were nephrotic and two had CKD (stage 3). Late administration of colchicine could not reverse the course.

Conclusions:

The National long-term program on early diagnosis and regular colchicine treatment of FMF in children in Armenia is only partly effective in prevention of renal amyloidosis and requires additional efforts. Colchicine is not able to reverse advanced amyloid nephropathy.