Korean J Med.  2015 Aug;89(2):259-263. 10.3904/kjm.2015.89.2.259.

TNF-alpha Inhibitor Treatment in an Ankylosing Spondylitis Patient with Secondary Amyloidosis that Manifest with Diarrhea: A Case Report

• Lee JH
• Moon J
• Lee HW
• Chang SH
• Lee EB
• Song YW
• Lee EY

• KMID: 2269041
• DOI: http://doi.org/10.3904/kjm.2015.89.2.259

Abstract

Secondary amyloidosis (Amyloid A amyloidosis) occurs when serum amyloid S accumulates in various tissues and organs. It often accompanies chronic inflammatory disease, especially rheumatoid arthritis, as well as ankylosing spondylitis (AS) and Crohn's disease. Although amyloid deposits were reported in 7% of the abdominal fatty tissue samples from AS patients, most of the patients had no symptoms. In a large study, 1.1% of 730 patients with AS were diagnosed with amyloidosis. Most of them showed renal involvement, while none had gastrointestinal symptoms. In South Korea, only a few cases of gastrointestinal involvement of secondary amyloidosis have been reported in AS patients, and there is no report on the effect of a tumor necrosis factor (TNF)-alpha inhibitor. We report a case of secondary amyloidosis in an AS patient who improved with the TNF-alpha inhibitor etanercept.

Keyword

Amyloidosis; Spondylitis, Ankylosing; TNFR-Fc fusion protein

MeSH Terms

Adipose Tissue
Amyloid
Amyloidosis*
Arthritis, Rheumatoid
Crohn Disease
Diarrhea*
Humans
Korea
Plaque, Amyloid
Spondylitis, Ankylosing*
Tumor Necrosis Factor-alpha*
Etanercept
Amyloid
Tumor Necrosis Factor-alpha