Treatment of AA amyloidosis in rheumatoid arthritis.
Four patients of rheumatoid arthritis (RA) with biopsy confirmed AA amyloidosis were treated with chlorambucil. All had established but uncontrolled RA with a persistently raised ESR. Moderate (> 1 gm, < 3.5 gm/d) to nephrotic range (> 3.5 gm/d) proteinuria and a relatively well preserved renal function was noted in three patients. One patient had deranged renal function and required dialysis. On chlorambucil, there was complete recovery, partial improvement and no improvement in one patient each. The fourth patient required haemodialysis, did not tolerate chlorambucil and succumbed to the illness. Therapy with chlorambucil can benefit some patients of RA with AA amyloidosis. Leucopenia is the most important dose limiting side effect.
Department of Rheumatology, PD Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai.
C
C
Balakrishnan
A
A
Sule
G
G
Mittal
S
S
Gaitonde
E
E
Pathan
S
S
Rajadhyaksha
R B
RB
Deshpande
M
M
Gurmeet
R
R
Samant
V R
VR
Joshi
D000328:Adult; D000686:Amyloidosis / Q000188:drug therapy*; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D002699:Chlorambucil / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged
D018906:Antineoplastic Agents, Alkylating; D002699:Chlorambucil