AA Amyloidosis: Mount Sinai Experience, 1997–2012

Bunker, Daniel Lee John; Gorevic, Peter D.

doi:10.1002/msj.21342

Cited by 44 publications

(34 citation statements)

References 44 publications

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“…In contrast, recent case series from Boston, New York, Minnesota, Japan, and Turkey have found an exceedingly low frequency of injection drug use (0%-4%) among patients with AA amyloidosis and an identifiable chronic inflammatory disorder in nearly all cases of disease (12,14,18,19). Although differences in disease ascertainment and reporting may have accounted for some of this discrepancy, the marked geographic variation suggests that the type of heroin preparation may differentially affect the development of the disease.…”

Section: Discussionmentioning

confidence: 92%

“…For example, a recent case series from San Francisco reported 24 patients with biopsy-proven kidney AA amyloidosis; all were chronic heroin users and many had recurrent skin infections due to exhaustion of their injection sites (11). On the other hand, the plurality of case series describing AA amyloidosis in the kidneys have reported an exceedingly low frequency of heroin use (5,(12)(13)(14). For example, among 374 patients referred to the United Kingdom National Amyloidosis Center from 1990 to 2005, the prevalence of injection drug use was only 4% (5).…”

Section: Introductionmentioning

confidence: 99%

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Heroin Use Is Associated with AA-Type Kidney Amyloidosis in the Pacific Northwest

Sharma¹,

Govindan²,

Toukatly³

et al. 2018

CJASN

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Background and objectives AA-type kidney amyloidosis is classically associated with chronic autoimmune or inflammatory disorders. However, some urban centers have reported a high prevalence of injection drug use among patients with kidney AA amyloidosis. Previous reports lack control groups to quantify associations and most predate the opioid epidemic in the United States.Design, setting, participants, & measurements We conducted a case-control study of 38 patients with biopsyconfirmed kidney AA amyloidosis and 72 matched control individuals without this condition from two large hospital systems in Seattle, Washington. We ascertained the pattern and duration of heroin use by medical chart review and determined associations using logistic regression.Results Among case patients, 95% had a prior history of heroin use, 87% had skin abscesses, and 76% and 27% had evidence of muscling and skin popping, respectively. After adjustment for age, race, sex, site, and year of biopsy, any heroin use (past or current) was associated with an estimated 170-times higher risk of kidney AA amyloidosis compared with no heroin use (95% confidence interval, 28 to 1018 times higher; P,0.001). Chronic autoimmune disorders were uncommon among case patients in this study. The median time to ESKD among patients with AA amyloidosis was 2.4 years (interquartile range, 0.5-7.5 years).Conclusions Injection heroin use is strongly associated with kidney AA amyloidosis in the Pacific Northwest. Unique aspects of heroin use, in particular geographic regions or frequent associated soft-tissue infections, may be an important cause of this progressive kidney disease.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Heroin Use Is Associated with AA-Type Kidney Amyloidosis in the Pacific Northwest

Sharma¹,

Govindan²,

Toukatly³

et al. 2018

CJASN

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“…Bunun yanında genetik yatkınlıkla beraber uzun süre inflamatuvar sürece maruz kalma, SAA düzeyini yükselterek, sekonder amiloidoz oluşumunu kolaylaştırır (22)(23)(24). CRP, SAA gibi inflamatuvar belirteç olarak amiloidoz olgularında yüksek seyretmektedir (25). Çalışmamızda inflamatuvar belirteç olarak CRP ve SAA düzeyleri yüksek bulundu, ancak AA ve AL grubu arasında anlamlı fark saptamadık.…”

Section: Türk Nefroloji Diyaliz Ve Transplantasyon Dergisi Turkish Neunclassified

The Evaluation of Amyloidosis Cases with Renal Involvement: A Single-Center Experience

Ayar¹,

Yıldız²,

Sayilar³

et al. 2015

Turk Neph Dial Transpl

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“…It is usually ''secondary'' to a chronic inflammatory condition, such as rheumatoid arthritis, juvenile chronic polyarthritis, ankylosing spondylitis, inflammatory bowel disease, familial Mediterranean fever, or a chronic infection. [18][19][20][21][22] It can affect a variety of organs, including the kidneys. The development of nephrotic syndrome in a patient with a chronic inflammatory condition is often suggestive of AA amyloidosis, but biopsy confirmation is required for the diagnosis.…”

mentioning

confidence: 99%

“…23 If left untreated, AA amyloidosis has significant mortality due to end-stage renal disease, infection, heart failure, bowel perforation, or gastrointestinal bleeding. 19,21,24 However, successful treatment of the underlying condition can lead to stabilization or improvement of renal function. 21 Systemic wild-type ATTR amyloidosis (formerly agerelated or senile systemic amyloidosis) refers to the deposition of unmutated transthyretin in tissues, often in the myocardium, in elderly individuals.…”

mentioning

confidence: 99%

Amyloidosis of the Lung

Khoór¹,

Colby²

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Amyloidosis is a heterogeneous group of diseases characterized by the deposition of congophilic amyloid fibrils in the extracellular matrix of tissues and organs. To date, 31 fibril proteins have been identified in humans, and it is now recommended that amyloidoses be named after these fibril proteins. Based on this classification scheme, the most common forms of amyloidosis include systemic AL (formerly primary), systemic AA (formerly secondary), systemic wild-type ATTR (formerly age-related or senile systemic), and systemic hereditary ATTR amyloidosis (formerly familial amyloid polyneuropathy). Three different clinicopathologic forms of amyloidosis can be seen in the lungs: diffuse alveolar-septal amyloidosis, nodular pulmonary amyloidosis, and tracheobronchial amyloidosis. Objective.—To clarify the relationship between the fibril protein–based amyloidosis classification system and the clinicopathologic forms of pulmonary amyloidosis and to provide a useful guide for diagnosing these entities for the practicing pathologist. Data Sources.—This is a narrative review based on PubMed searches and the authors' own experiences. Conclusions.—Diffuse alveolar-septal amyloidosis is usually caused by systemic AL amyloidosis, whereas nodular pulmonary amyloidosis and tracheobronchial amyloidosis usually represent localized AL amyloidosis. However, these generalized scenarios cannot always be applied to individual cases. Because the treatment options for amyloidosis are dependent on the fibril protein–based classifications and whether the process is systemic or localized, the workup of new clinically relevant cases should include amyloid subtyping (preferably with mass spectrometry–based proteomic analysis) and further clinical investigation.

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AA Amyloidosis: Mount Sinai Experience, 1997–2012

Cited by 44 publications

References 44 publications

Heroin Use Is Associated with AA-Type Kidney Amyloidosis in the Pacific Northwest

Heroin Use Is Associated with AA-Type Kidney Amyloidosis in the Pacific Northwest

The Evaluation of Amyloidosis Cases with Renal Involvement: A Single-Center Experience

Amyloidosis of the Lung

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