ABSTRACT
AIM: To characterize renal amyloidosis in patients with rheumatoid arthritis and stages of amyloid nephropathy. MATERIAL AND METHODS: The trial covered 30 patients (6 males and 24 females) with documented rheumatoid arthritis (RA) complicated with secondary AA-amyloidosis. Amyloidosis diagnosis was confirmed in all the patients morphologically, the samples were studied with the peroxidase immunohistochemical method using specific monoclonal antibodies to SAA. Clinical manifestations of RA were assessed by the disease activity, functional impairment of the joints, x-ray alterations, extraarticular signs of RA, etc. All the patients were examined clinically, total blood count and biochemical tests were made. RESULTS: In 23 (77%) of 30 examinees with RA, proteinuria as the first clinical symptom of AA-amyloidosis emerged with the first 15 years of RA. RA of the second-third degree of activity were diagnosed in 25 (83%) patients, 21 (70%) patients had apparent destructive changes in the joints (x-ray stage III-IV). Severe functional insufficiency of the joints was observed in 25 (83%) patients, deformation of the joints - in 27 (90%) patients. Clinically, renal amyloidosis was characterized by change of stages - from moderate proteinuria to nephrotic syndrome and renal failure. Prognosis of amyloid nephropathy in RA depends on duration of the proteinuric stage: if this stage is short (3 years maximum), the prognosis is worse than in its long duration. CONCLUSION: RA ranks first among causes of secondary AA-amyloidosis. Development of AA-amyloidosis in RA patients is most probable in the first 15 years of the course of the articular process. Amyloidosis is more frequent in patients with severe clinical manifestations of RA.
Subject(s)
Amyloidosis/epidemiology , Arthritis, Rheumatoid/epidemiology , Adult , Age of Onset , Aged , Amyloidosis/metabolism , Arthritis, Rheumatoid/metabolism , Biopsy , C-Reactive Protein/metabolism , Female , Humans , Kidney/pathology , Male , Middle Aged , Prevalence , Severity of Illness IndexSubject(s)
Amyloidosis , Age Factors , Aged , Aged, 80 and over , Amyloidosis/diagnosis , Amyloidosis/epidemiology , Amyloidosis/etiology , Global Health , Humans , Incidence , Risk FactorsSubject(s)
Amyloidosis/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Dexamethasone/therapeutic use , Doxorubicin/therapeutic use , Multiple Myeloma/drug therapy , Vincristine/therapeutic use , Amyloidosis/complications , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Dexamethasone/administration & dosage , Doxorubicin/administration & dosage , Humans , Male , Middle Aged , Multiple Myeloma/complications , Treatment Outcome , Vincristine/administration & dosageABSTRACT
We studied the efficiency and safety of a new homeopathic preparation Artrofoon containing affinely purified antibodies to tumor necrosis factor-alpha in the therapy of patients with rheumatoid arthritis. Artrofoon produced a positive antiinflammatory effect on the course of rheumatoid arthritis. This preparation reduced the severity of arthralgia (indexes of Li and Ritchie) and morning stiffness and decreased the erythrocyte sedimentation rate and contents of rheumatoid factor and C-reactive protein. One-month therapy improved the state of patients. Artrofoon was well tolerable. The preparation did not cause the ulcerogenic and nephrotoxic effects. Artrofoon holds much promise for combination therapy of patients with rheumatoid arthritis (including severe articular-and-visceral forms) and complications after treatment with nonsteroid antiinflammatory preparations.
Subject(s)
Antibodies/therapeutic use , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Tumor Necrosis Factor-alpha/immunology , Adult , Aged , Antibodies, Monoclonal/immunology , Antibodies, Monoclonal/therapeutic use , Arthritis, Rheumatoid/metabolism , Arthritis, Rheumatoid/pathology , Female , Humans , Male , Middle Aged , Treatment OutcomeSubject(s)
Amyloidosis/genetics , Familial Mediterranean Fever/genetics , Amyloidosis/diagnosis , Amyloidosis/drug therapy , Colchicine/therapeutic use , Cytoskeletal Proteins , Familial Mediterranean Fever/diagnosis , Familial Mediterranean Fever/drug therapy , Humans , Proteins/genetics , Pyrin , Serum Amyloid A Protein/analysisABSTRACT
Here is an observation data on systemic AL-amiloidosis with primary lesion of lungs and vessels (a false hemorrhagic syndrome, ischemic insult in the region of middle cerebral artery). At the same time lesions of kidneys and heart became of minor significance. Amiloid lesion of lungs was characterized by unusual combination of symptoms: a galloping hydrothorax, a vast focus in the consolidation of pulmonary tissue with focuses of calcification, relapsing pneumothorax.
