CASE HISTORY

The patient, a man aged 41, was admitted with loin pain, lassitude and hamarturia. 8 months earlier, in S Rhodesia, he had been investigated for "acute nephritis". He had had asthma for 20 years and chest x-rays showed apical shadows, thought to be tuberculosis. IVP - Kidneys enlarged, dye excretion poor. BU -95mg%. At this stage he discharged himself, but the symptoms increased and he was admitted in semicoma 6 months later, grossly oliguric. Chvostek's sign +ive. Blood urea 185mg%. Serum bicarb 10meq/LSerum Ca 6.5mg%, Serum K 7.2 m.eq/L. Despite treatment on a conservative anuric regime he steadily deteriorated and died 5 weeks later.

PATHOLOGY

The kidneys are of different size, and the left one weighed 8oz, the right one 5 oz. The latter has been immersed in congo red to show the extent of the amyloid. The left kidney is pale and its markings are blurred.