Secondary amyloidosis as a cause of nephrotic syndrome in Takayasu arteritis

Renal involvement in Takayasu arteritis (TA) has been reported, but glomerular lesions causing nephrotic syndrome (NS) are rare. This is a case report of TA presenting with NS due to secondary amyloidosis.A woman in her late 40s was diagnosed as TA at the age of 15 years presented with nephrotic range proteinuria. She was not treated previously for her illness. Her infective, immunological, autoimmune diseases and paraproteinaemia workup were negative. Renal biopsy had confirmed the diagnosis as secondary amyloidosis.She was treated with oral steroids, mycophenolate mofetil and adalimumab. At 6 months she underwent transfemoral coronary, pulmonary, peripheral angiogram and percutaneous transluminal angioplasty (PTA) with stenting of left subclavian and left renal artery.In patients with inadequately treated TA and nephrotic range proteinuria, renal AA amyloidosis is not an uncommon diagnosis. Systemic amyloidosis is an adverse prognostic sign in TA, and it is imperative to have a high index of suspicion.