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Published in: Rheumatology International 2/2011

01-02-2011 | Case Report

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

Authors: Wataru Ishii, Dai Kishida, Ayako Suzuki, Yasuhiro Shimojima, Masayuki Matsuda, Yoshinobu Hoshii, Shu-ichi Ikeda

Published in: Rheumatology International | Issue 2/2011

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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.
Literature
1.
go back to reference Husby G, Marhaug G, Dowton B, Sletten K, Sipe JD (1994) Serum amyloid A (SAA): biochemistry, genetics and the pathogenesis of AA amyloidosis. Amyloid 1:119–137CrossRef Husby G, Marhaug G, Dowton B, Sletten K, Sipe JD (1994) Serum amyloid A (SAA): biochemistry, genetics and the pathogenesis of AA amyloidosis. Amyloid 1:119–137CrossRef
2.
go back to reference Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P (2007) New therapies for treatment of rheumatoid arthritis. Lancet 370:1861–1874CrossRefPubMed Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P (2007) New therapies for treatment of rheumatoid arthritis. Lancet 370:1861–1874CrossRefPubMed
3.
go back to reference Elkayam O, Hawkins PN, Lachmann H, Yaron M, Caspi D (2002) Rapid and complete resolution of proteinuria due to renal amyloidosis in a patient with rheumatoid arthritis treated with infliximab. Arthritis Rheum 46:2571–2573CrossRefPubMed Elkayam O, Hawkins PN, Lachmann H, Yaron M, Caspi D (2002) Rapid and complete resolution of proteinuria due to renal amyloidosis in a patient with rheumatoid arthritis treated with infliximab. Arthritis Rheum 46:2571–2573CrossRefPubMed
4.
go back to reference Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B et al (2003) Anti-tumor necrosis factor α therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a follow-up report of tolerability and efficacy. Arthritis Rheum 48:2019–2024CrossRefPubMed Gottenberg JE, Merle-Vincent F, Bentaberry F, Allanore Y, Berenbaum F, Fautrel B et al (2003) Anti-tumor necrosis factor α therapy in fifteen patients with AA amyloidosis secondary to inflammatory arthritides: a follow-up report of tolerability and efficacy. Arthritis Rheum 48:2019–2024CrossRefPubMed
5.
go back to reference Fernández-Nebro A, Tomero E, Ortiz-Santamaría V, Castro MC, Olivé A, de Haro M et al (2005) Treatment of rheumatic inflammatory disease in 25 patients with secondary amyloidosis using tumor necrosis factor alpha antagonists. Am J Med 118:552–556CrossRefPubMed Fernández-Nebro A, Tomero E, Ortiz-Santamaría V, Castro MC, Olivé A, de Haro M et al (2005) Treatment of rheumatic inflammatory disease in 25 patients with secondary amyloidosis using tumor necrosis factor alpha antagonists. Am J Med 118:552–556CrossRefPubMed
6.
go back to reference Okuda Y, Takasugi K (2006) Successful use of a humanized anti-interleukin-6 receptor antibody, tocilizumab, to treat amyloid A amyloidosis complicating juvenile idiopathic arthritis. Arthritis Rheum 54:2997–3000CrossRefPubMed Okuda Y, Takasugi K (2006) Successful use of a humanized anti-interleukin-6 receptor antibody, tocilizumab, to treat amyloid A amyloidosis complicating juvenile idiopathic arthritis. Arthritis Rheum 54:2997–3000CrossRefPubMed
7.
go back to reference Kuroda T, Otaki Y, Sato H, Fujimura T, Nakatsue T, Murakami S et al (2008) A case of AA amyloidosis associated with rheumatoid arthritis effectively treated with infliximab. Rheumatol Int 28:1155–1159CrossRefPubMed Kuroda T, Otaki Y, Sato H, Fujimura T, Nakatsue T, Murakami S et al (2008) A case of AA amyloidosis associated with rheumatoid arthritis effectively treated with infliximab. Rheumatol Int 28:1155–1159CrossRefPubMed
8.
go back to reference Hoshii Y, Kiyama M, Cui D, Kawano H, Ishihara T (2006) Immunohistochemical study of immunoglobulin light chain amyloidosis with antibodies to the immunoglobulin light chain variable region. Pathol Int 56:324–330CrossRefPubMed Hoshii Y, Kiyama M, Cui D, Kawano H, Ishihara T (2006) Immunohistochemical study of immunoglobulin light chain amyloidosis with antibodies to the immunoglobulin light chain variable region. Pathol Int 56:324–330CrossRefPubMed
9.
go back to reference Ishii W, Matsuda M, Nakamura A, Nakamura N, Suzuki A, Ikeda S (2003) Abdominal fat aspiration biopsy and genotyping of serum amyloid A contribute to early diagnosis of reactive AA amyloidosis secondary to rheumatoid arthritis. Intern Med 42:800–805CrossRefPubMed Ishii W, Matsuda M, Nakamura A, Nakamura N, Suzuki A, Ikeda S (2003) Abdominal fat aspiration biopsy and genotyping of serum amyloid A contribute to early diagnosis of reactive AA amyloidosis secondary to rheumatoid arthritis. Intern Med 42:800–805CrossRefPubMed
10.
go back to reference Kuroda T, Tanabe N, Harada T, Murakami S, Hasegawa H, Sakatsume M et al (2006) Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis. Clin Rheumatol 25:498–505CrossRefPubMed Kuroda T, Tanabe N, Harada T, Murakami S, Hasegawa H, Sakatsume M et al (2006) Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis. Clin Rheumatol 25:498–505CrossRefPubMed
11.
go back to reference Okuda Y, Takasugi K, Oyama T, Oyama H, Nanba S, Miyamoto T (1997) Intractable diarrhoea associated with secondary amyloidosis in rheumatoid arthritis. Ann Rheum Dis 56:535–541CrossRefPubMed Okuda Y, Takasugi K, Oyama T, Oyama H, Nanba S, Miyamoto T (1997) Intractable diarrhoea associated with secondary amyloidosis in rheumatoid arthritis. Ann Rheum Dis 56:535–541CrossRefPubMed
12.
go back to reference Moriguchi M, Terai C, Koseki Y, Uesato M, Nakajima A, Inada S et al (1999) Influence of genotypes at SAA1 and SAA2 loci on the development and the length of latent period of secondary AA-amyloidosis in patients with rheumatoid arthritis. Hum Genet 105:360–366CrossRefPubMed Moriguchi M, Terai C, Koseki Y, Uesato M, Nakajima A, Inada S et al (1999) Influence of genotypes at SAA1 and SAA2 loci on the development and the length of latent period of secondary AA-amyloidosis in patients with rheumatoid arthritis. Hum Genet 105:360–366CrossRefPubMed
13.
go back to reference Moriguchi M, Terai C, Koseki Y, Kaneko H, Uesato M, Nishikawa T et al (2001) Genotypes at SAA1 locus correlate with the clinical severity of AA-amyloidosis. Amyloid 8:115–120PubMed Moriguchi M, Terai C, Koseki Y, Kaneko H, Uesato M, Nishikawa T et al (2001) Genotypes at SAA1 locus correlate with the clinical severity of AA-amyloidosis. Amyloid 8:115–120PubMed
14.
go back to reference Lachmann HJ, Goodman HJB, Gilbertson JA, Gallimore JR, Sabin CA, Gillmore JD et al (2007) Natural history and outcome in systemic AA amyloidosis. N Engl J Med 356:2361–2371CrossRefPubMed Lachmann HJ, Goodman HJB, Gilbertson JA, Gallimore JR, Sabin CA, Gillmore JD et al (2007) Natural history and outcome in systemic AA amyloidosis. N Engl J Med 356:2361–2371CrossRefPubMed
15.
go back to reference Fushimi T, Takahashi Y, Kashima Y, Fukushima K, Ishii W, Kaneko K et al (2005) Severe protein losing enteropathy with intractable diarrhea due to systemic AA amyloidosis, successfully treated with corticosteroid and octreotide. Amyloid 12:48–53CrossRefPubMed Fushimi T, Takahashi Y, Kashima Y, Fukushima K, Ishii W, Kaneko K et al (2005) Severe protein losing enteropathy with intractable diarrhea due to systemic AA amyloidosis, successfully treated with corticosteroid and octreotide. Amyloid 12:48–53CrossRefPubMed
16.
go back to reference Tsuchiya A, Yazaki M, Kametani F, Takei Y, Ikeda S (2008) Marked regression of abdominal fat amyloid in patients with familial amyloid polyneuropathy during long-term follow-up after liver transplantation. Liver Transpl 14:563–570CrossRefPubMed Tsuchiya A, Yazaki M, Kametani F, Takei Y, Ikeda S (2008) Marked regression of abdominal fat amyloid in patients with familial amyloid polyneuropathy during long-term follow-up after liver transplantation. Liver Transpl 14:563–570CrossRefPubMed
17.
go back to reference Richter GW (1954) The resorption of amyloid under experimental conditions. Am J Pathol 30:239–262PubMed Richter GW (1954) The resorption of amyloid under experimental conditions. Am J Pathol 30:239–262PubMed
Metadata
Title
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
Authors
Wataru Ishii
Dai Kishida
Ayako Suzuki
Yasuhiro Shimojima
Masayuki Matsuda
Yoshinobu Hoshii
Shu-ichi Ikeda
Publication date
01-02-2011
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 2/2011
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-009-1205-z

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