Clinical outcome and survival of secondary (AA) amyloidosis.
OBJECTIVE
In order to predict the clinical outcome of secondary (AA) amyloidosis patients with rheumatic diseases, we studied the clinical features at presentation of AA amyloidosis.


METHODS
We investigated the clinical characteristics and survival of 42 patients with biopsy-proven AA amyloidosis who were followed up in our department from 1983 to 2001.


RESULTS
A presenting factor which adversely influenced clinical outcome was a raised serum creatinine concentration at the time AA amyloidosis was diagnosed. Eight of 42 patients survived for 10 years or more after the presentation of AA amyloidosis, while 24 patients had died within 10 years. At the diagnosis of AA amyloidosis, cardiac involvement was detected in 11 of 24 non-survivors, whereas it was not detected in any of the 8 long-term survivors. Estimated survival at 5 years was 31.3% in those who had cardiac involvement, and was 63.3% in those who had no cardiac involvement at the presentation of AA amyloidosis.


CONCLUSIONS
Our results indicate that clinical outcome is related to renal function and cardiac involvement at the time AA amyloidosis is diagnosed. Amyloid-related cardiac involvement is one of the unfavorable predictive factors in AA amyloidosis patients.
Tanaka
F
F
First Department of Internal Medicine, Nagasaki University Graduate School of Biochemical Sciences, Sakamoto 1-7-1, Nagasaki 852-8501, Japan.
Migita
K
K
Honda
S
S
Fukuda
T
T
Mine
M
M
Nakamura
T
T
Yamasaki
S
S
Ida
H
H
Kawakami
A
A
Origuchi
T
T
Eguchi
K
K
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000686:Amyloidosis / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis; D002423:Cause of Death; D016001:Confidence Intervals; D018450:Disease Progression; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D000685:Serum Amyloid A Protein / Q000032:analysis*; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors
D000685:Serum Amyloid A Protein