An unusual case of AA amyloidosis is presented. Pharmacotherapy of rheumatoid arthritis induced its 5-year clinical remission, yet despite this, the patient developed AA amyloidosis. Amyloidosis involved the stomach, duodenum and kidneys. AA amyloidosis did not impair the renal functions significantly. This case emphasized the importance of non-targeted bio­psies of macroscopically normal mucosa of the stomach and duodenum that made it possible to dia­gnose amyloidosis. The patient remained without any gastrointestinal symptoms even during the subsequent follow-up. Key words: AA amyloidosis – gastroscopy – non-targeted bio­psies

Previous studies suggest that there may be an association between cancer and autoimmune diseases. We describe the case of a 59-year-old patient who did not have any significant diseases in the last year. She had new onset of fever of unknown aetiology, headache, fatigue and night sweats. We used laboratory methods to rule out infectious diseases. Significant laboratory findings reported increased signs of inflammation and anti-nuclear antibody (ANA) positivity. Positron emission tomography/computed tomography (PET/CT) imaging showed the origin of the patient’s difficulties, arteritis, with increased metabolic activity in the aortic wall and other arteries. Doppler ultrasonography of the arteries did not show pathology in the temporal arteries but found accelerated blood flow in the superior mesenteric artery (AMS). Another finding from PET/CT was a tumour in the thyroid gland, later verified histologically as papillary thyroid carcinoma (PTC). We investigated the link between rheumatological disease and papillary carcinoma, applying similar therapy, corticosteroids and immunosuppressants.