Beta 2 microglobulin-related amyloidosis causing atlantoaxial spondylarthropathy with spinal-cord compression in haemodialysis patients: detection by MRI.

Abstract

Bone destruction due to beta-2 microglobulin (beta 2-M)-related amyloid deposition is becoming more frequently observed in long-term haemodialysis patients. We report five cases in an unusual site, the upper cervical spine. All patients had been on haemodialysis for more than 13 years and presented with progressive spinal-cord involvement in the region of the first and second cervical nerves. While conventional X-rays and CT scans showed only minor vertebral destruction, MRI disclosed a tumour-like mass within the upper spinal canal, best seen with long TR gradient recalled images. One patient required urgent surgical intervention because of severe spinal-cord compression, and the material was shown to be typically beta 2-M-related amyloid.