[Beneficial effect of salazosulfapyridine (SASP) in a patient with secondary renal amyloidosis].
A 55-year old female with rheumatoid arthritis (RA) had presented with proteinuria since July 1996. She was referred to us for persistent edema on her face and legs in November 1996. On admission, her 24-hour urinary protein excretion was 4.4 g/day, total serum protein level was 5.3 g/dl, and serum level of amyloid A protein (SAA) was elevated to 45.8 mg/ml. A percutaneous renal biopsy was performed, and light microscopy revealed varying degrees of amyloid deposits in the mesangial areas and arteriolar walls. The diagnosis of secondary amyloidosis (AA amyloidosis) was based on immunohistochemical staining for amyloid A protein using monoclonal antibody against SAA. Four weeks after treatment with salazosulfapyridine (SASP) and dipyridamole, proteinuria began to decrease and the edema had disappeared. Finally she recovered from nephrotic syndrome. AA amyloidosis has been thought to have a poor prognosis, with progression to renal failure. Since there is no specific effective therapy for the disease, it is very important to reduce the activity of the underlying cause. In our patient with renal amyloidosis following RA, SASP was evidently effective for arthritis and improvement of renal function. SASP might have a beneficial effect on AA amyloidosis by suppressing inflammatory cytokines.
Hidaka
M
M
Second Department of Internal Medicine, Nihon University, Tokyo, Japan.
Ohsawa
I
I
Endo
M
M
Fujita
T
T
Ohi
H
H
Kanmatsuse
K
K
Kusumi
Y
Y
Yamaguchi
Y
Y
D000686:Amyloidosis / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000150:complications*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D008875:Middle Aged; D000685:Serum Amyloid A Protein / Q000378:metabolism; D012460:Sulfasalazine / Q000008:administration & dosage*; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000685:Serum Amyloid A Protein; D012460:Sulfasalazine