Inflammatory Bowel Disease and Systemic AA Amyloidosis

Sattianayagam, Prayman T.; Gillmore, Julian D.; Pinney, Jennifer H.; Gibbs, Simon; Wechalekar, Ashutosh; Gilbertson, Janet A.; Rowczenio, Dorota; Hawkins, Philip N.; Lachmann, HJ

doi:10.1007/s10620-012-2549-x

Cited by 40 publications

(15 citation statements)

References 23 publications

(30 reference statements)

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“…SSA, or AA amyloidosis, has been reported as a complication of IBD and was first described in 1936 [ 14 ]. Further research has supported this association between the two conditions [ 10 - 12 , 14 - 16 ] and it has been reported that SSA is more frequently present in patients with CD than in those with UC [ 14 ]. The incidence of SSA associated with IBD in the United States is estimated at 0.9% in patients with CD and 0.07% in those with UC [ 10 ].…”

Section: Discussionmentioning

confidence: 88%

“…It has been hypothesized that the predominance of SSA in CD patients may be related to the more pronounced acute phase and a higher prevalence of suppurative features among these patients. Another study suggested that the incidence of amyloidosis secondary to CD is decreasing, probably in response to better and newer treatment methods including the use of biologic agents [ 12 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…SSA is a rare extra-intestinal manifestation of this disease [ 9 ]. An association between IBD and AA amyloidosis has been reported in prior case reports, case series and observational studies [ 10 - 12 ]. In this study, we aimed to understand the natural history of SSA, including demographics, comorbidity, in-hospital mortality and predictors of mortality in IBD patients.…”

Section: Introductionmentioning

confidence: 92%

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Secondary systemic amyloidosis in inflammatory bowel disease: a nationwide analysis

Sharma

Aguilar

Siddiqui

et al. 2017

aog

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BackgroundSecondary systemic amyloidosis (SSA) is a rare but severe complication of inflammatory bowel disease (IBD). We aimed to evaluate the clinical characteristics, predictors of complications, and in-hospital mortality of patients with Crohn’s disease (CD) and Ulcerative colitis (UC) who develop SSA.MethodsUsing the National Inpatient Sample, we identified patients hospitalized for IBD and SSA between 2004 and 2012. Using multivariate logistic regression, patients with CD were compared with those with UC regarding the presence or absence of SSA. IBD patients without SSA were matched in a 2:1 ratio with those with SSA using propensity matching. We analyzed the hospitalization trends of SSA in CD and UC patients using Pearson’s χ2 test. Analyses were performed using SAS version 9.3.ResultsAmong the 302,548 patients with CD and 174,057 patients with UC hospitalized between 2004 and 2012, we identified 47 (0.02%) and 36 (0.02%) cases of SSA, respectively. We noted rising annual hospitalization trends for both CD and UC patients with or without SSA. In-hospital mortality was significantly higher for both the UC+SSA group (16.7% vs. 2.1%, P<0.0001) and the CD+SSA group (6.4% vs. 1.0%, P=0.0001) before propensity matching. However, this difference was not seen for either UC+SSA (17.1% vs. 7.1%, P=0.11) or CD+SSA (6.8% vs. 2.3%, P=0.20) after matching.ConclusionsSSA rarely affects IBD patients, but when it does, it is associated with increased rates of infection, severe sepsis, and multi-organ system involvement. Despite this, SSA does not affect in-hospital mortality in IBD patients. Further studies are needed to explore this association.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 92%

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Secondary systemic amyloidosis in inflammatory bowel disease: a nationwide analysis

Sharma

Aguilar

Siddiqui

et al. 2017

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“…The conclusions that vigorous treatment including anti-tumour necrosis factor (TNF)-a agents of Crohn's disease (CD) complicated by AA amyloidosis, reduce amyloid A production, were confirmed [22][23][24]. Long survival after kidney transplantation for end-stage renal disease was also confirmed [24]. However failure of anti-TNF-a therapy of secondary AAamyloidosis was reported.…”

Section: Control Of Aa Amyloidosis Complicating Crohn'smentioning

confidence: 96%

Research update for articles published inEJCIin 2013

Abbate

Al-Daghri

Andreozzi

et al. 2015

Eur J Clin Investigation

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“…Renal amyloidosis is a rare but serious complication of IBD, and is associated with significant morbidity and even mortality burden [37]. Secondary amyloidosis, the predominant type of amyloidosis in patients with IBD, is characterised by extracellular deposition of serum amyloid A, an acute phase reactant protein in different parts of the kidneys, leading to proteinuria or renal insufficiency [38]. Deposition of amyloid in the glomeruli will usually lead to proteinuria and/or nephrotic syndrome, while interstitial amyloid accumulation will result in renal insufficiency [39].…”

Section: Amyloidosismentioning

confidence: 99%

Renal involvement in paediatric inflammatory bowel disease

Mutalib

2019

Pediatr Nephrol

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Inflammatory bowel disease (IBD), which includes Crohn's disease, ulcerative colitis and inflammatory bowel disease unclassified, is a chronic inflammatory disorder that predominantly affects the gastrointestinal (GI) tract and has a rising incidence in both children and adults. Symptoms are caused by inappropriate inflammatory response triggered by interaction between the environment, gut microbiome and host immune system in a genetically susceptible individual. Extranintestinal manifestations of IBD are common and can affect any body system outside the gut; they can precede or run parallel to GI inflammation. Renal involvement in IBD is uncommon and can be part of extraintestinal manifestation or metabolic complications of IBD. Many medications used to treat IBD can cause renal damage. Renal manifestation in children with IBD can range from asymptomatic biochemical abnormalities to variable stages of renal impairment with significant morbidity and even mortality burden.

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Inflammatory Bowel Disease and Systemic AA Amyloidosis

Cited by 40 publications

References 23 publications

Secondary systemic amyloidosis in inflammatory bowel disease: a nationwide analysis

Secondary systemic amyloidosis in inflammatory bowel disease: a nationwide analysis

Research update for articles published inEJCIin 2013

Renal involvement in paediatric inflammatory bowel disease

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