Clinical Case Report: LECT2-Associated Adrenal Amyloidosis

ABSTRACT Objective: Leukocyte chemotactic factor-2 (LECT2)- associated amyloidosis is a newly discovered cause of amyloid and has thus far been reported to involve only the kidneys. We report a case of amyloidosis of the adrenal gland, along with involvement of the kidney, in a patient with primary aldosteronism. Methods: Tissue samples from the patient were analyzed using tandem mass spectrometry to identify the amyloid protein, followed by Western blot. DNA sequencing was performed to evaluate genetic polymorphisms. Results: Tandem mass spectrometry identified the amyloid protein as LECT2, and its identity was confirmed by Western blot. Genetic analysis revealed the patient to be homozygous for a genetic polymorphism of the LECT2 gene. Serum levels of LECT2 were undetectable, and no mutations were found in the CTNNB1, KCNJ5, ATP1A1, or ATP2B3 genes. Conclusion: This case appears to be the first published report to describe LECT 2-associated amyloidosis both outside of the kidney and within the adrenal gland. Abbreviations: CT computed tomography CTNNB1 catenin (cadherin-associated protein), beta 1 LDL low-density lipoprotein LECT2 leukocyte chemotactic factor-2 LECT2 AA LECT2-associated amyloid A amyloidosis PA primary aldosteronism SDS sodium dodecyl sulfate