Long-term Follow-up of Systemic Reactive AA Amyloidosis Secondary to Rheumatoid Arthritis: Successful Treatment with Intermediate-dose Corticosteroid.

Abstract

Reactive AAamyloidosis frequently develops in patients with a long history of rheumatoid arthritis (RA), usually resulting in an unfavorable outcomedue to dysfunction of the vital organs. Wereport a 56-year-old womanwith this form of amyloidosis secondary to RAwhohas been successfully treated with intermediate-dose prednisolone for two and a half years since diagnosis. Because prednisolone is superior to other drugs used for amyloidosis with respect to possible harmful effects on vital organs, we can safely try this drug as an alternative therapy to improve the prognosis even in patients with severe organ dysfunction. (Internal Medicine 41 : 403-407, 2002)

Clinical and Endoscopic Features of Amyloidosis Secondary to Crohn's Disease: Diagnostic Value of Duodenal Observation and Biopsy

“…Generally, AMY is more likely to be a complication of long‐term persisting chronic inflammatory diseases, such as chronic infection and collagen diseases. Among patients with rheumatoid arthritis (a disease commonly complicated by AMY), the risk for AMY is considered to be higher in patients with highly active rheumatoid arthritis 17–19 . In terms of the relationship between CD duration and the risk for AMY, some investigators have reported no association, 7,10 whereas others have found a strong association 2 .…”

“…Among patients with rheumatoid arthritis (a disease commonly complicated by AMY), the risk for AMY is considered to be higher in patients with highly active rheumatoid arthritis. [17][18][19] In terms of the relationship between CD duration and the risk for AMY, some investigators have reported no association, 7,10 whereas others have found a strong association. 2 Thus, there is no consensus on this relationship.…”

Prognostic Factors for Renal Amyloidosis:A Clinicopathological Study Using Cluster Analysis

“…The therapeutic options for renal amyloidosis have been discussed in many studies (5)(6)(7)(8)(9)(10)(11)(12)(13) …”

Amyloid A Amyloidosis Secondary to Rheumatoid Arthritis: An Uncommon Yet Important Complication

“…Corticosteroids are capable of reducing the magnitude of the acute phase reaction including the synthesis of CRP and SAA. It seems reasonable to treat patients with AA amyloidosis secondary to RA using cytostatic drugs either alone or in combination with prednisolone [8,14,[103][104][105][106]. Although corticosteroid therapy suppressess both CRP and SAA levels in longitudinal studies of patients with RA, the effect is somewhat more pronounced for CRP than for SAA [102].…”