Hereditary gelsolin amyloidosis mimicking Sjögren's syndrome.
Hereditary gelsolin amyloidosis (AGel amyloidosis) belongs to the wide group of amyloidotic diseases, which comprise various hereditary but also sporadic forms, such as inflammation-associated AA amyloidosis, primary or myeloma-associated AL amyloidosis and common Alzheimer's disease and type II diabetes-associated local amyloidoses. AGel amyloidosis caused by a gelsolin G654A gene mutation is autosomally dominantly inherited and presents typically in the 30s with progressive corneal lattice dystrophy, followed by cutis laxa and cranial polyneuropathy. Here, we present a case of sicca syndrome, originally diagnosed as primary Sjögren's syndrome (SS) but later found to represent an initial disease manifestation of AGel amyloidosis, not recognised earlier. This case emphasises both the importance of specific amyloid stainings and comprehensive salivary gland histopathology as well as family history in SS differential diagnostics.
Juusela
Pirjo
P
Department of Oral Biology, Institute of Dentistry, University of Helsinki, Helsinki, Finland. pirjo.juusela@fimnet.fi
Tanskanen
Maarit
M
Nieminen
Anja
A
Uitto
Veli-Jukka
VJ
Blåfield
Harri
H
Kiuru-Enari
Sari
S
D000682:Amyloid / Q000378:metabolism; D028226:Amyloidosis, Familial / Q000175:diagnosis* / Q000235:genetics / Q000378:metabolism; D003937:Diagnosis, Differential; D005192:Family Health; D005260:Female; D018260:Gelsolin / Q000032:analysis / Q000235:genetics*; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000150:complications / Q000473:pathology; D009154:Mutation; D012470:Salivary Glands, Minor / Q000378:metabolism / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications / Q000175:diagnosis*; D014985:Xerophthalmia / Q000150:complications / Q000473:pathology; D014987:Xerostomia / Q000150:complications / Q000473:pathology
D000682:Amyloid; D018260:Gelsolin
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