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Hidradenitis suppurativa resulting in systemic amyloid A amyloidosis: A case report and review of the literature.
MedLine Citation:
PMID:  22301039     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Hidradenitis suppurativa is a chronic, inflammatory disease of the follicular epithelium that presents as tender, subcutaneous nodules in an intertriginous distribution with sinus tract formation. Most commonly, hidradenitis suppurativa results in local complications, such as scarring and infection. However, systemic complications, such as anemia and arthropathies, have also been described. Herein, we report an unusual case of systemic amyloid A secondary to hidradenitis suppurativa. We describe a 39-year-old man with a long history of recurrent, tender, erythematous nodules in the axillary and anogenital regions, resulting in abscesses, sinus tract formation, and large areas of scarring. After 21 years of cutaneous disease with concurrent elevated systemic inflammatory markers, the patient was noted to have significant proteinuria. A kidney biopsy and immunostaining revealed deposits of amyloid A. Echocardiogram and electrocardiogram showed ventricular and atrial wall thickening with an appearance consistent with cardiac amyloid deposition. Systemic amyloid A amyloidosis is a serious, but rare, complication of chronic inflammatory disorders, including hidradenitis suppurativa, with potential multi-organ involvement including renal and cardiac manifestations. Amyloid A amyloidosis should be suspected in patients with chronic inflammatory cutaneous diseases who present with renal abnormalities, especially proteinuria or the nephrotic syndrome.
Authors:
Sasha D Girouard; Rodney H Falk; Helmut G Rennke; Joseph F Merola
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Publication Detail:
Type:  Journal Article     Date:  2012-01-15
Journal Detail:
Title:  Dermatology online journal     Volume:  18     ISSN:  1087-2108     ISO Abbreviation:  Dermatol. Online J.     Publication Date:  2012  
Date Detail:
Created Date:  2012-02-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610776     Medline TA:  Dermatol Online J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2     Citation Subset:  IM    
Affiliation:
Harvard Medical School, Boston, Massachusetts.
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