Summary
The study reports an aluminium-intoxicated haemodialysis patient who had encephalopathy, osteomalacia and congestive cardiomyopathy prior to his death. Detailed light and electron microscope examination revealed the presence of aluminium deposits within lysosomes of cells from many organs, including the kidney, liver, brain and heart. The heavy aluminium deposits in myocardial lysosomes favor a possible role of the trace element in the patient's congestive cardiomyopathy.
Similar content being viewed by others
References
Alfrey AC, Le Gendre GR, Kaehny WD (1976) The dialysis encephalopathy syndrome: possible aluminum intoxication. New Engl J Med 294:184–8
Alfrey AC, Hegg A, Craswell P (1980) Metabolism and toxicity of aluminum in renal failure. Am J Clin Nutr 33:1509–16
Berlyne GJ, Ben Ari J, Weinberger J, Stern M, Gilmore GR, Levin ER (1970) Hyperaluminaemia from aluminium resins in renal failure. Lancet I:494–6
Berlyne GM, Yagil R, Ben Ari J, Weinberger G, Knopf E, Danovitch GM (1972) Aluminium toxicity in rats. Lancet I:564–7
Berry JP, Henoc P, Galle P (1978) Phagocytosis by cells of the pulmonary alveoli: transformation of crystalline particles. Am J Pathol 93:27–44
Berry JP, Houdry J, Galle P, Lagrue G (1978) Chromium concentration by proximal renal tubule cells: an ultrastructural, microanalytical and cytochemical study. J Histochem 26:651–7
Buge A, Poisson M, Masson S, Bleibel JM, Lafforgue B, Raymond P, Jaudon MC (1978) Encéphalopathie prolongée et réversible chez un dialysé chronique: responsabilité probable des sels d'aluminium. Nouv Presse Med 7:2053–9
Buge A, Escourolle R, Poisson M, Gray F, Bleibel JM, Jaudon MC (1979) Encéphalopathie progressive des dialysés: Rôle de 1'aluminium et étude neuropathologieque. Nouv Presse Med 8:1071–4
Cartier F, Allain P, Gary J, Menault F, Pecker S (1978) Encéphalopathie myoclonique progressive des dialysés: rôle de l'eau utilisée pour l'hémodialyse. Nouv Presse Med 7:97–102
Chokroverty S, Bruetman ME, Berger V, Ryes MG (1976) Progressive dialytic encephalopath. J Neurol Psychiatr 39:411–19
Cournot-Witmer G, Zingraff J, Bourdon R, Drueke T, Balsan S (1979) Aluminium and dialysis bone disease. Lancet II:795–6
Cournot-Witmer G, Zingraff J, Plachot JJ, Esraig F, Lefevre R, Boumati P, Bourdeau A, Garadedoran M, Galle P, Drueke T, Balsan S (1981) Aluminium localization in bone from hemodialysis patients: Relationship to matrix mineralization. Kidney Intern 20:375–85
Crapper DR, Krishnan SS, Quittkat S (1976) Aluminium neurofibrillary degeneration and Alzheimer's disease. Brain 99:67–75
De Boni U, Otvos A, Scott J, Crapper DR (1976) Neurofibrillary degeneration induced by systemic aluminium. Acta Neuropathol (Berlin) 35:285–94
De Boni U, Scott J, Crapper DR (1974) Intracellular aluminium binding on histochemical study. Histochemistry 40:31–7
Drueke T (1980) Dialysis osteomalacia and aluminium intoxication. Nephron 26:207–10
Drueke T, Le Pailleur C, Sigal-Saglier M, Zingraff J, Crosnier J, Di Matteo J (1981) Left ventricular function in hemodialyzed patients with cardiomegaly. Nephrology 28:80–7
Duckett S, White R (1974) Cerebral lipofuscinosis induced with tellerium: electron dispensive X ray spectrometry analysis. Brain Res 173:205–14
Duckett S, Galle P (1976) X-ray microanalysis of pallidal arteries in Parkinson's disease. In: Sixth European Congress on Electron Microscopy, Jerusalem pp 210–211
Duckett S (1976) Alzheimer's disease and aluminium. Arch Neurol 33:730–731
Duckett S, Galle P (1976) Evidence of aluminium in senile plaques of Alzheimer disease: Castaing microprobe study. Comptes rendus Acad Sci (D) (Paris) 282:393–396
Duckett S, White RG (1974) Cerebral lipofuscinosis induced with tellerium: electron dispersive X-ray spectrophotometry analysis. Brain Res 73:205–214
Duckett S, Galle P, Escourolle R, Grey F (1976) Présence d'aluminium et de magnésium au niveau des artères et du parenchyme cérébral de maldes atteints de syndrome striatonigré: étude à la microsonde de Castaing. Comptes rendus Acad Sci (D) (Paris) 282:2215–2218
Duckett S, Galle P, Escourolle R, Poirier J, Hauw H (1977) Presence of zinc, aluminium, magnesium in striopallidodentate (SPD) calcifications (Fahr's disease). Acta Neuropathol (Berlin) 38:7
Duckett S, Galle P, Kradim R (1977) The relationship between Parkinson's syndrome and vascular siderosis: an electron microprobe study. Ann Neurol 2:225–230
Elliott HL, Mac Dougall L, Fell GS (1978) Aluminium toxicity syndrome. Lancet I:1203
Flendrig JA, Kruis H, Das HA (1976) Aluminium intoxication: the cause of dialysis dementia. Proc. 13th Congr Eur Dial Transp Assoc, Hamburg 355–363
Flendrig JA, Kruis H, Das HA (1976) Aluminium and dialysis dementia. Lancet I:1235
Galle P (1974) Rôle des lysosomes et des mitochondries dans les phénomènes de concentration d'élimination d'éléments minéraux (uranium et or) par le rein. J Microsc 19:17–24
Galle P, Chatel M, Berry JP, Menault F (1979) Encéphalopathie myoclonique progressive des dialysés. Nouv Press Med 8, 50:4091–4094
Galle P, Giudicelli CP (1982) Toxicité de l'aluminium pour l'hépatocyte. Localisations ultrastructurales et micro-analyse des dépôts. Nouv Presse Med 11:1123
Galle P, Berry JP, Duckett S (1980) Electron microprobe ultrastructural localization of aluminium in rat brain. Acta Neuropathol 49:245–247
Galle P, Berry JP (1980) The role of acid phosphatases in the concentration of some mineral elements in lysosomes. Elec Micros 3:92–93
Galle P (1981) Physiologie animale. Mécanisme d'élimination rénale de l'aluminium et l'indium. Comptes rendus Acad Sci Paris 292:91–96
Hager H (1968) Electron microscopy of nervous tissues. In: Minckler New York (ed) Pathology of the nervous system. McGraw Hill Publ. New York 1968
Klatzo I, Wisniewski H, Streicher J (1965) Experimental production of neurofibrillary degeration I. Light microscopic observations. J Neuropathol Exp Neurol 24:187–198
Kushelevsky A, Yagil R, Alfasi Z, Berlyne GM (1976) Uptake of aluminium ion by the liver. Biomedicine 25:59–60
Lapresle J, Duckett S, Galle P, Cartier L (1975) Documents cliniques, anatomiques et biophysiques, dans une encéphalopathie avec présence de dépôts d'aluminium. Comptes rendus Soc Biol (Paris) 159:282–285
Lefevre R, Cournot-Witmer G (1980) Electron microprobe analysis and analytical ionmicroscopy of normal and pathological bone (dialysis osteomalacia). Elec Micros 3:106–107
Levine S, Sowinski R (1978) Lymphocytic inflammation produced by intracerebral implantation of zinc and other metals. J Neuropathol Exp Neurol 37:471–480
McDermott JR, Smith AI (1978) Brain aluminium concentration in dialysis encephalopathy. Lancet II:901–903
McLaughlin AIG, Kazantzis G, King E, Teare D, Porter RJ, Owen R (1962) Pulmonary fibrosis and encephalopathy associated with the inhalation of aluminium dust. Br J Int Med 18:253–263
Masbernard A, Piette JC, Giudicelli CP, Lafforgue B, Beaulaton A, Jaudon MC (1977) Encephalopathie progressive des dialysés. Nouv Presse Med 6:2172
Mayor GH, Keiser JA (1977) Aluminium absorption and distribution: effect of parathyroid hormone. Science 197:1187–1189
Mayor GH, Hook JB, Rech RH, Noordewier B, Sprague SM, Keiser JA, McCormack KM (1978) Study of PTH, vitamin D, calcium, and aluminium kinetics and dialysis encephalopathy. Transactions 11th Meeting Am Soc Nephrology New Orelans 36–40
Miller CA, Levine EM (1974) Effects of aluminum salts on cultured neuroblastoma cells. J Neurochem 22:751–758
O'Hare JA, Murnaghan DJ (1982) Reversal of aluminum induced hemodialysis anemia by low-aluminum dialysate. New Engl J Med 306:654–656
Petri E (1930) Pathologische Anatomie und Histologie der Vergiftungen In: Henke F, Lubarsch O (Hrsg) Handbuch der speziellen pathologischen Anatomie und Histologie, Bd 10, Springer, Berlin, pp 62–63
Plachot JJ, Cournot-Witmer G, Halpern S, Mendes V, Bourdeau A, Drueke T, Galle P, Balsan S (1984 in press) Bone ultrastructure and X-ray microanalysis of aluminum intoxicated hemodialyzed patients. Kid Intern
Platts MM, Hislop JS (1976) Aluminium and dialysis encephalopathy. Lancet II:98
Poisson M, Lebkiri B, Mashaly R (1978) Dialysis encephalopathy recovery after interruption of aluminium intake. Br Med J 2:1610–1611
Sabouraud O, Chatel M, Menault F, Cartier F, Garre M, Gary J, Pecker S (1978) L'encéphalopathie myoclonique des dialysés: étude clinique, électroncéphalographique et neuropathologique. Rev Neurol 134:575–602
Scherp HW, Church CR (1937) Neurotoxic action of aluminium salts. Proc Soc Exp Biol 36:851–853
Sears WG, Eales L (1973) Aluminium induced porphyria in the rat. ICRS. Med Sciences 1:13
Siebert F, Wells H (1929) The effect of aluminium on mammalian blood and tissues. Arch Pathol 8:230–261
Sternlief I, Goldfischer S (1976) Heavy metals and lysosomes. In Neuberger A, Tatum FL (eds) Frontiers in biology. Elsevier, Amsterdam, pp 185–200
Terry RD, Pena C (1965) Experimental production of neurofibrillary degeneration. Electron microscopy, phosphatases, histochemistry and electron probe analysis. J Neuropathol Exp Neurol 24:200–210
Touam M, Martinez F, Lacour B, Bourdon R, Zingraff J, Di Giulio S, Drueke T (1983) Aluminium induced, reversible microcytic anemia in chronic renal failure: clinical and experimental studies. Clin Nephrol 19:295–298
Truchet M (1976) Mise en évidence par microanalyse sonde électronique et par microanalyse ionique, de localisations naturelles d'aluminium dans les noyaux de divers types cellulaires. CR Acad Sc Paris 282:1782–1788
Truchet A, Trottier S (1978) Contribution du filtre éléctrostatique et de l'optique de transfert équipé de la galette de microcanaux à l'étude des épilepsies expérimentals en analyse ionique. J Microsc 3:463–467
Ward MK, Feest TG, Ellis HA, Parkinson IS, Kerr DNS (1978) Osteomalacie dialysis osteodystrophy: evidence for a waterbone aetiological agent, probably aluminium. Lancet 1:841–845
Wisniewski A, Terry RD, Hinano A (1970) Neurofibrillary pathology. J Neuropathol Exp Neurol 29:163–175
Yasui M, Yoshimasu F, Yase Y, Uebayashi Y (1979) Wilson's disease: increased aluminium in liver. Filio Psychiatr Neurol J 33, 4:457–552
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Roth, A., Nogues, C., Galle, P. et al. Multiorgan aluminium deposits in a chronic haemodialysis patient. Vichows Archiv A Pathol Anat 405, 131–140 (1984). https://doi.org/10.1007/BF00694931
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00694931