KIDNEY, RIGHT, PERCUTANEOUS RENAL BIOPSY:
In summary, this patient has advanced chronic renal disease secondary to deposition of amyloid A within the kidney. Amyloid A is a recognized complication of chronic inflammatory disorders including rheumatoid arthritis. Extra-renal amyloid involvement should be assessed. In spite of the clinical history of rheumatoid vasculitis, there is no evidence of an active vasculitis or glomerulonephritis in the kidney biopsy; prior (healed) renal necrotizing vasculitis/glomerulonephritis cannot be excluded.
Contributed by Jianzhou Wang, MD., PhD., Sheldon Bastacky, MD