A case with rheumatoid arthritis and systemic reactive AA amyloidosis showing rapid regression of amyloid deposition on gastroduodenal mucosa after a combined therapy of corticosteroid and etanercept

Rheumatol Int. 2011 Feb;31(2):247-50. doi: 10.1007/s00296-009-1205-z. Epub 2009 Oct 10.

Abstract

Systemic reactive amyloid A (AA) amyloidosis is one of the critical complications associated with rheumatoid arthritis (RA). Recently, there are several useful reports of anti-tumor necrosis factor therapy for RA-related systemic reactive AA amyloidosis patients. However, the time-kinetic transition between effective anti-inflammatory therapies and regression of AA amyloid deposits remains uncertain. Here, we report a RA patient with systemic reactive AA amyloidosis who was successfully treated with prednisolone and etanercept, showing marked regression of gastroduodenal mucosal amyloid deposits within only 4 months. This is the first case report of RA-related systemic reactive AA amyloidosis histopathologically demonstrating rapid regression of amyloid deposits on gastroduodenal mucosa after adequate suppression of the underlying inflammatory condition.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amyloidosis / diagnosis
  • Amyloidosis / drug therapy*
  • Amyloidosis / pathology
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / pathology
  • Drug Therapy, Combination*
  • Etanercept
  • Gastric Mucosa / chemistry
  • Gastric Mucosa / drug effects*
  • Humans
  • Immunoglobulin G / therapeutic use*
  • Male
  • Plaque, Amyloid / drug therapy*
  • Plaque, Amyloid / pathology
  • Prednisolone / therapeutic use*
  • Receptors, Tumor Necrosis Factor / therapeutic use*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Immunoglobulin G
  • Receptors, Tumor Necrosis Factor
  • Prednisolone
  • Etanercept