Document Detail


Amyloidosis is frequently undetected in patients with rheumatoid arthritis.
MedLine Citation:
PMID:  19065298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Prevalence of AA amyloid in rheumatoid arthritis (RA) is still unclear. The objective of this retrospective study was whether dedicated re-examination of autopsy tissues from RA patients increases the detection rate of amyloid compared to routine examination. Amyloid was re-examined in tissue samples and detection rate compared with original reports of 369 consecutively autopsied RA patients and 370 non-RA patients matched for sex, age, and year of autopsy between 1952 and 1991. Re-examination of 90% of the 739 cases showed doubling of the prevalence of amyloid compared with the original reports: from 18 to 30% in RA and from 2 to 4% in non-RA patients. In RA patients, cardiac amyloid was as frequent as renal amyloid. In RA patients with amyloid at re-examination, amyloidosis had been diagnosed before autopsy in 37%, and these patients had more inflammation and longer disease duration than RA patients without amyloid. Only 56% of RA patients with renal amyloid were known to have proteinuria. In conclusion, this autopsy study shows that amyloid in RA is a common finding which remains frequently undetected. In patients with active and long-lasting RA, a systematic search for amyloid may enable early diagnosis of amyloidosis, which will require effective suppression of inflammation.
Authors:
Riitta Koivuniemi; Leena Paimela; Risto Suomalainen; Tom Tornroth; Marjatta Leirisalo-Repo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis     Volume:  15     ISSN:  1744-2818     ISO Abbreviation:  Amyloid     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-09     Completed Date:  2009-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433802     Medline TA:  Amyloid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  262-8     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. riitta.koivuniemi@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Aged
Amyloidosis / complications*,  diagnosis*,  metabolism,  mortality
Arthritis, Rheumatoid / complications*,  metabolism,  mortality
Autopsy
Cause of Death
Female
Finland / epidemiology
Humans
Male
Middle Aged
Retrospective Studies
Serum Amyloid A Protein / metabolism
Chemical
Reg. No./Substance:
0/Serum Amyloid A Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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