RENAL AMYLOIDOSIS IN A DRUG-ABUSER

Drug abusers, particularly those who inject drugs s.c. (''skin popping''), may develop amyloidosis, Chronic infections are thought to play a pathogenetic role in this setting. A patient is presented who had a history of ''skin popping'' cocaine and heroin and developed nephrotic syndrome, with an elevated serum creatinine and a creatinine clearance of 61 ml/min. Renal biopsy demonstrated amyloidosis. Treatment with colchicine was initiated, and proteinuria decreased to near normal levels after 12 months, Concomitant with the decrease in proteinuria, creatinine clearance improved, although a repeat renal biopsy failed to show any significant improvement in amyloid burden. These observations suggest that colchicine may be a useful treatment in reversing the proteinuria of renal amyloidosis associated with drug abuse. Furthermore, clinical improvement may occur before any demonstrable regression in the amyloidosis.