J Korean Rheum Assoc.  2004 Dec;11(4):326-332.

Clinical Manifestations of Secondary Amyloidosis Associated with Rheumatoid Arthritis

• Lee SW
• Lee JH
• Kim KH
• Chung WT

Abstract

OBJECTIVE
In order to study the clinical manifestations in 17 cases of secondary amyloidosis with rheumatoid arthritis (RA).
METHODS
We investigated the clinical characteristics and survival of 17 RA (8 men and 9 women) patients with biopsy-proven secondary amyloidosis who were followed up in our department from 1998 to 2004 by medical records review.
RESULTS
The mean age and duration of RA at diagnosis of amyloidosis were 58.4 (range 35~81) years and 7.8 (range 2~33) years respectively. Upper gastrointestinal tract biopsy was performed in 14, rectal and abdominal fat biopsy in 4 and 2, and renal and bladder biopsy in 3 and 2 patients respectively. Sixteen patients (94.1%) were diagnosed as secondary amyloidosis by endoscopic biopsy. Common symptoms were diarrhea and abdominal pain. Serological activities determined by C-reactive protein (CRP) and erythrocyte sedimentation rates (ESR) were moderate to high in the patients. Three patients died 2 to 45 (mean 19.3) months after the diagnosis of amyloidosis. One patient died of sepsis after etanercept therapy for treatment of RA, the other of intractable diarrhea, and another of acute myocardial infarction.
CONCLUSION
Our results indicate that the mainly involved organ in secondary amyloidosis associated with RA is gastrointestinal tract rather than kidney and the biopsy in the second portion of duodenum may be a good diagnostic tool for the evaluation of secondary amyloidosis.

Keyword

Rheumatoid arthritis; Amyloidosis

MeSH Terms

Abdominal Fat
Abdominal Pain
Amyloidosis*
Arthritis, Rheumatoid*
Biopsy
Blood Sedimentation
C-Reactive Protein
Diagnosis
Diarrhea
Duodenum
Gastrointestinal Tract
Humans
Kidney
Male
Medical Records
Myocardial Infarction
Sepsis
Upper Gastrointestinal Tract
Urinary Bladder
Etanercept
C-Reactive Protein