title: Oral dimethyl sulfoxide for systemic amyloid A amyloidosis complication in chronic inflammatory disease: a retrospective patient chart review.
abstract: BACKGROUND
  Amyloid A amyloidosis is an obstinate disease complication in chronic inflammatory disease, and there are few effective therapies. The objective of this study was to investigate the effect of oral dimethyl sulfoxide (DMSO) on amyloid A amyloidosis.
  
  
  METHODS
  Fifteen secondary amyloid A amyloidosis patients (4 men, 11 women; age, 23-70 years) were treated with DMSO between 1995 and 2003. DMSO was administered orally in all patients at a dose of 3-20 g/day. The clinical symptoms together with the renal and gastrointestinal functions were evaluated before and after treatment.
  
  
  RESULTS
  Among the 15 patients, amyloid A amyloidosis was a complication of rheumatoid arthritis (RA) in 10, of Crohn's disease in 4, and of Adult Still's disease in 1. Nine cases mainly involved the kidney, with renal dysfunction and proteinuria, five mainly involved the gastrointestinal tract, with protein-losing gastroenteropathy and intractable diarrhea, and one involved both gastrointestinal and renal amyloidosis. DMSO treatment was successful in 10 (66.7%) of the 15 patients (RA, 6/10; Crohn's disease, 4/4; Adult Still's disease, 0/1). Eight weeks of DMSO administration improved the renal function and proteinuria in five out of ten renal amyloidosis patients, but had no effect on those patients with severe and/or advanced renal dysfunction. With regard to gastrointestinal amyloidosis, gastrointestinal symptoms, including diarrhea and protein-losing gastroenteropathy, were improved in six patients. No serious side effects were encountered with the DMSO treatment.
  
  
  CONCLUSIONS
  Oral administration of DMSO is an effective treatment for amyloid A amyloidosis, especially for gastrointestinal involvement and the early stage of renal dysfunction.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Japan.
authors.forename: Sadahiro
authors.initials: S
authors.lastname: Amemori
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Endo
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ootani
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ogata
authors.forename: Takahiro
authors.initials: T
authors.lastname: Noda
authors.forename: Seiji
authors.initials: S
authors.lastname: Tsunada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Hisashi
authors.initials: H
authors.lastname: Matsunaga
authors.forename: Masanobu
authors.initials: M
authors.lastname: Mizuguchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000188:drug therapy*; D003967:Diarrhea / Q000517:prevention & control; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D000685:Serum Amyloid A Protein; D013272:Stomach Diseases / Q000517:prevention & control
chemical_list: D000685:Serum Amyloid A Protein; D004121:Dimethyl Sulfoxide