ab21309

Clinical outcome and survival of secondary (AA) amyloidosis

F. Tanaka, K. Migita, S. Honda, T. Fukuda¹, M. Mine², T. Nakamura³, S. Yamasaki, H. Ida, A. Kawakami, T. Origuchi, K. Eguchi

First Department of Internal Medicine, Na-gasaki University Graduate School of Biochemical Sciences, Sakamoto, Nagasaki; ¹First Department of Internal Medicine, Kurume University School of Medicine; ²Department of Internal Medicine, Isahaya Health Insurance Hospital; ³Faculty of Environmental Studies, Nagasaki University, Japan.

ABSTRACT
Objective
In order to predict the clinical outcome of secondary (AA) amyloidosis patients with rheumatic diseases, we studied the clinical features at presentation of AA amyloidosis.

Methods
We investigated the clinical characteristics and survival of 42 patients with biopsy-proven AA amyloidosis who were followed up in our department from 1983 to 2001

Results
A presenting factor which adversely influenced clinical outcome was a raised serum creatinine concentration at the time AA amyoidosis was diagnosed. Eight of 42 patients survived for 10 years or more after the presentation of AA amyloidosis, while 24 patients had died within 10 years. At the diagnosis of AA amyloidosis, cardiac involvement was detected in 11 of 24 non-survivors, whereas it was not detected in any of the 8 long-term survivors. Estimated survival at 5 years was 31.3% in those who had cardiac involvement, and was 63.3% in those who had no cardiac involvement at the presentation of AA amyloidosis.

Conclusion
Our results indicate that clinical outcome is related to renal function and cardiac involvement at the time AA amyloidosis is diagnosed. Amyloid-related cardiac involvement is one of the unfavorable predictive factors in AA amyloidosis patients.

Key words
Secondary amyloidosis, serum amyloid A protein, rheumatic disease.

Please address correspondence and reprint requests to: Katsumi Eguchi, MD, First Department of Internal Medicine, Nagasaki University Graduate School of Biochemical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
E-mail: eguchi @ net. nagasaki-u. ac. jp