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Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis

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Abstract

It is well established that amyloidosis is a serious clinical complication that can influence the prognosis of patients with rheumatoid arthritis (RA). The purpose of the study was to obtain information on the survival and the hemodialysis (HD) of patients with amyloidosis. Eighty patients (9 men and 71 women) who were diagnosed with amyloidosis by biopsy and definite or classical RA were studied retrospectively. The average duration of RA prior to the diagnosis of amyloidosis was 15.4±9.4 years. The average period from the diagnosis of amyloidosis to death was 67.4 months. Forty-nine patients died of the disease (32 cases with HD and 17 cases without HD). Thirty-one patients lived (7 cases with HD and 24 cases without HD). Regarding the survival of these patients, 49 (61.3%) of the 80 patients have died. Survival rate at 28 months was 75%; at 67 months, it was 50%; and at 111 months, it was down to 25%. Mortality rate was 11.9% per year. Survival rate in dialysis at 9.8 months was 75%; at 60.6 months, it dropped to 50%; and at 100.0 months, to 25%. As for patients' survival, high onset age of amyloidosis was the major determining factor for poor survival in these patients (p<0.001). Furthermore, male patients also had poor survival (p=0.07). The long-term results were very encouraging to initiate HD in patients with end-stage renal disease due to reactive amyloidosis associated with RA.

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References

  1. Glenner GG (1980) Amyloid deposits and amyloidosis: the β-fibrillosis. N Engl J Med 302:1283–1292

    Article  PubMed  CAS  Google Scholar 

  2. Suzuki A, Ohoshone Y, Obana M, Mita S, Matsuoka Y, Irimajiri S et al (1994) Cause of death in 81 autopsied patients with rheumatoid arthritis. J Rheumatol 21:33–36

    PubMed  CAS  Google Scholar 

  3. Mutru O, Laakso M, Isomaki H, Koota K (1985) Ten-year mortality and cause of death in patients with rheumatoid arthritis. Br Med J 290:1797–1799

    Article  CAS  Google Scholar 

  4. Rally PA, Cosh JA, Maddison PJ, Rasker JJ, Silman AJ (1990) Mortality and survival in rheumatoid arthritis: a 25-year prospective study of 100 patients. Ann Rheum Dis 49:363–369

    PubMed  Google Scholar 

  5. Mutru O, Koota K, Isomaki HA (1976) Cause of death in autopsied rheumatoid arthritis patients. Scand J Rheumatol 5:239–240

    Article  PubMed  CAS  Google Scholar 

  6. Berglund K, Thysell H, Keller C (1993) Results, principles and pitfalls in management of renal AA-amyloidosis: a 10–21 year follow up of 16 patients with rheumatic disease treated with alkylating cytostatics. J Rheumatol 20:2051–2057

    PubMed  CAS  Google Scholar 

  7. Kobayashi H, Tada S, Fuchigami T, Okuda Y, Takasugi K, Matsumoto T et al (1996) Secondary amyloidosis in patients with rheumatoid arthritis: diagnostic and prognostic value of gastroduodenal biopsy. Br J Rheumatol 35:44–49

    Article  PubMed  CAS  Google Scholar 

  8. Husby G (1985) Amyloidosis and rheumatoid arthritis. Clin Exp Rheumatol 3:173–180

    PubMed  CAS  Google Scholar 

  9. Kuroda T, Tanabe N, Sakatsume M, Nozawa S, Mituska T, Ishikawa H et al (2002) Comparison of gastroduodenal, renal and abdominal fat biopsies for diagnosing amyloidosis in rheumatoid arthritis. Clin Rheumatol 21:123–128

    Article  PubMed  CAS  Google Scholar 

  10. Breedveld FC, Markusse HM, MacFarlane JD (1989) Subcutaneous fat biopsy in the diagnosis of amyloid secondary to chronic arthritis. Clin Exp Rheumatol 7:407–410

    PubMed  CAS  Google Scholar 

  11. Sorsa S, Happonen RP, Klemi P (1988) Oral biopsy and fine needle aspiration biopsy from subcutaneous fat in diagnosis of secondary amyloidosis. Int J Oral Maxillofac Surg 17:14–16

    Article  PubMed  CAS  Google Scholar 

  12. Tada S, Iida M, Iwashita A, Matsui T, Fuchigami T, Yamamoto T et al (1990) Endoscopic and biopsy findings of the upper digestive tract in patients with amyloidosis. Gastrointest Endosc 36:10–14

    Article  PubMed  CAS  Google Scholar 

  13. Ylinen K, Gronhagaen-Riska C, Honkanen E, Ekstrand A, Metsarinne K, Kuhlback B (1992) Outcome of patient with secondary amyloidosis in dialysis treatment. Nephrol Dial Transplant 7:908–912

    PubMed  CAS  Google Scholar 

  14. Hezemans RLJJM, Krediet RT, Arisz L (1995) Dialysis treatment in patients with rheumatoid arthritis. Neth J Med 47:6–11

    Article  PubMed  CAS  Google Scholar 

  15. Arnett FC, Edworthy SM, Bloch AD, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  16. Steinbrocker O, Traeger CH, Betteman RC (1949) Therapeutic criteria in rheumatoid arthritis. JAMA 140:659–662

    CAS  Google Scholar 

  17. Dhillon V, Woo P, Isenberg D (1989) Review—amyloidosis in the rheumatic diseases. Ann Rheum Dis 48:969–971

    Google Scholar 

  18. van der Heijde DMFM, van't Hof MA, van Riel PLCM et al (1992) Validity of single variables and composite indices for measuring disease activity in rheumatoid arthritis. Ann Rheum Dis 52:177–181

    Article  Google Scholar 

  19. Japanese Society for Dialysis Therapy (2002) An overview of regular dialysis treatment in Japan (as of Dec 31, 2001). Japanese Society for Dialysis Therapy, Tokyo, pp 155–163

  20. Gerts MA, Kyle RA (1991) Secondary systemic amyloidosis: response and survival in 64 patients. Medicine 70:246–256

    PubMed  Google Scholar 

  21. Mitchell DM, Spitz PW, Young DY, Bloch DA, McShane DJ, Fries JF (1986) Survival, prognosis, and causes of death in rheumatoid arthritis. Arthritis Rheum 29:706–714

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata City, 951-8510, Japan

    Takeshi Kuroda, Takashi Harada, Syuichi Murakami, Hisashi Hasegawa, Minoru Sakatsume & Fumitake Gejyo

  2. Division of Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Niigata City, 951-8510, Japan

    Naohito Tanabe

  3. Department of Medical Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-Dori, Niigata City, 951-8518, Japan

    Masaaki Nakano

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  1. Takeshi Kuroda
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  2. Naohito Tanabe
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  3. Takashi Harada
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  4. Syuichi Murakami
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  5. Hisashi Hasegawa
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  6. Minoru Sakatsume
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  7. Masaaki Nakano
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  8. Fumitake Gejyo
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Correspondence to Takeshi Kuroda.

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Kuroda, T., Tanabe, N., Harada, T. et al. Long-term mortality outcome in patients with reactive amyloidosis associated with rheumatoid arthritis. Clin Rheumatol 25, 498–505 (2006). https://doi.org/10.1007/s10067-005-0079-z

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  • DOI: https://doi.org/10.1007/s10067-005-0079-z

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