Long-term survival in systemic amyloid A amyloidosis complicating Crohn's disease

Lovat, Laurence; Madhoo, S; Pepys, Mark B.; Hawkins, Philip N.

doi:10.1016/s0016-5085(97)70150-1

Cited by 51 publications

(37 citation statements)

References 1 publication

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“…Systemic AA amyloidosis is a complication of various inflammatory diseases, including CD (1). Furthermore, renal failure resulting from amyloid nephropathy is a common cause of death in CD patients (2).…”

Section: Introductionmentioning

confidence: 99%

Successful Use of Maintenance Infliximab for Nephropathy in a Patient with Secondary Amyloidosis Complicating Crohn's Disease

et al. 2013

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Systemic AA amyloidosis is a complication of various inflammatory diseases including Crohn's disease (CD). Amyloid nephropathy is the most common clinical presentation of AA amyloidosis leading to renal failure, and affected patients often require hemodialysis and ultimately renal transplantation. We herein report the successful use of infliximab as maintenance therapy for amyloid nephropathy in a patient with CD. In the present patient, surgical treatment and infliximab infusion immediately induced a remission of CD, and scheduled infliximab therapy successfully maintained the patient's stable condition for three years, with a significant decrease in the serum creatinine level.

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Section: Introductionmentioning

confidence: 99%

Successful Use of Maintenance Infliximab for Nephropathy in a Patient with Secondary Amyloidosis Complicating Crohn's Disease

et al. 2013

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“…In a review of 374 cases of AA amyloidosis, the mean survival time from diagnosis was 133 months, with older age, reduced serum albumin concentration and endstage renal failure at baseline, and the degree by which the SAA concentration was elevated during follow-up were poor prognostic factors [1]. Successful treatment of the underlying inflammatory process, including with surgical resection of the tumour, as demonstrated in our case, can lead to the stabilisation of or improvement in renal function, reduction in protein excretion and partial resolution of amyloid deposits [17][18][19][20][21][22][23] (Fig. 7).…”

Section: Discussionmentioning

confidence: 63%

Renal cell carcinoma presenting as AA amyloidosis: a case report and review of the literature

Babu

Lachmann²,

Pickett

et al. 2013

CEN Case Rep

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A 47-year-old Caucasian man developed mild diarrhoea associated with more than 10 kg weight loss, severe fatigue and anaemia. Endoscopy demonstrated deposits of AA amyloid within the gastrointestinal tract. He had heavy proteinuria with a serum albumin of 15 g/L consistent with systemic AA amyloidosis. He had no symptoms to suggest an underlying chronic inflammatory condition but had CRP 130 mg/L and SAA 474 mg/L. In an attempt to identify the source of his inflammatory response, he underwent a contrast-enhanced whole-body computed tomography scan, which revealed a necrotising mass lesion in the right kidney consistent with a renal cell carcinoma. It also showed non-mechanical obstruction of the small bowel and, immediately post-imaging, the patient developed intractable vomiting followed by oliguric renal failure requiring haemodialysis. Despite his renal and gut failure, he underwent right radical nephrectomy without further complications. Histology showed complete resection of a clear cell renal cell carcinoma and renal amyloid deposits. Post-surgery, his acute-phase response decreased to normal, consistent with the renal cell carcinoma acting as the inflammatory stimulus. Although he remains dialysis dependent, his gut function improved and he has regained both normal weight and serum albumin. Our case demonstrates partial resolution of AA amyloidosis with removal of the inflammatory source.

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“…It has evolved from a post-mortem diagnosis [12] into a pre-mortem diagnosis [13]. This is largely due to an increased appreciation of the risk of AA amyloidosis together with an improvement in diagnostic techniques for amyloid including better histological diagnosis with immunohistochemistry and SAP scintigraphy [14].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Bowel Disease and Systemic AA Amyloidosis

Sattianayagam¹,

Gillmore²,

Pinney³

et al. 2013

Dig Dis Sci

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Long-term survival in systemic amyloid A amyloidosis complicating Crohn's disease

Cited by 51 publications

References 1 publication

Successful Use of Maintenance Infliximab for Nephropathy in a Patient with Secondary Amyloidosis Complicating Crohn's Disease

Successful Use of Maintenance Infliximab for Nephropathy in a Patient with Secondary Amyloidosis Complicating Crohn's Disease

Renal cell carcinoma presenting as AA amyloidosis: a case report and review of the literature

Inflammatory Bowel Disease and Systemic AA Amyloidosis

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