Charcot arthropathy secondary to amyloid neuropathy
S. J. Peitzman, J. L. Miller, L. Ortega, H. R. Schumacher and P. C. Fernandez
Neuropathic (Charcot) ankle joints developed in a 50-year-old patient with
end-stage renal disease from primary, nonfamilial amyloidosis. Sensory
neuropathy in the legs had been noted three years before the onset of
uremia and had porgressed. Sural nerve, but not synovial biopsy specimen,
showed amyloid in and around arteriolar walls by light and electron
microscopy. Since Charcot joints are only rarely associated with amyloid
neuropathy, it is possible that uremic neuritis, or prolonged survival by
dialysis, contributed to progression of the neuropathy, allowing subsequent
joint degeneration.
