Psoriatic spondyloarthropathy with secondary amyloidosis.
We report an HLA-B27 positive patient with severe psoriatic spondyloarthropathy who developed secondary reactive amyloidosis. The clinical course was characterized by progressive renal failure with nephrotic syndrome and cardiac dysfunction. He died suddenly and autopsy revealed diffuse amyloid deposits in the heart, kidneys, and many other organs. Amyloid deposits were present in the cardiac conduction system including the sinoatrial and atrioventricular nodes, myocardial interstitium, and intramyocardial small blood vessels. The severe AA amyloid deposit in the heart with involvement of conduction system is unusual, and has not been described in patients with psoriasis or psoriatic arthritis.
Ahmed
Q
Q
Department of Pathology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, 44109.
Chung-Park
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M
Mustafa
K
K
Khan
M A
MA
D000328:Adult; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D015535:Arthritis, Psoriatic / Q000150:complications*; D001283:Atrioventricular Node / Q000473:pathology; D001344:Autopsy; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis; D006801:Humans; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013166:Spondylitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D015796:HLA-B27 Antigen