Amyloid arthropathy and Waldenström macroglobulinemia.
Amyloid arthropathy occurs chiefly as a manifestation of beta(2) microglobulin amyloidosis in patients receiving chronic hemodialysis. AL amyloidosis complicating multiple myeloma is a less common cause. Amyloid arthropathy is exceedingly rare in patients with Waldenström macroglobulinemia. We report a case characterized by lymphoplasmocytoid malignancy with monoclonal IgM production and amyloid arthropathy manifesting as bilateral symmetric polyarthritis. A synovial membrane biopsy established the diagnosis. Chemotherapy was effective in alleviating the joint manifestations. Joint symptoms in patients with monoclonal gammopathies, including those characterized by IgM secretion, should suggest amyloid arthropathy. Treatment of the blood disease may improve the joint symptoms.
Gisserot
Olivier
O
Internal Medicine and Oncology Department, Sainte-Anne Armed Forces Teaching Hospital, 83800 Toulon Naval, France. oncologie@sianteanne.org
Landais
Cécile
C
Cremades
Serge
S
Terrier
Jean-Pierre
JP
Leyral
Guénaelle
G
Bernard
Philippe
P
de Jauréguiberry
Jean-Pierre
JP
D000368:Aged; D000686:Amyloidosis / Q000150:complications* / Q000473:pathology; D001182:Arthroscopy; D001706:Biopsy; D003937:Diagnosis, Differential; D018450:Disease Progression; D006801:Humans; D007592:Joint Diseases / Q000150:complications* / Q000473:pathology; D008297:Male; D008258:Waldenstrom Macroglobulinemia / Q000150:complications*