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MODERN RHEUMATOLOGY Vol.10 No.3
>MR10-3
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| Combined treatment with cyclophosphamide and prednisolone is effective for secondary amyloidosis with SAA1%/% genotype in a patient with rheumatoid arthritis |
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| T. Nakamura1, S. Baba2, Y. Yamamura1, T. Tsuruta1, S. Matsubara1, K. Tomoda1, M. Tsukano1 |
(1)Kumamoto Center for Arthritis and Rheumatology, 1-15-7 Kuhonji, Kumamoto 862-0947, Japan
(2)Department of Pathology II, Hamamatsu University School of Medicine, Hamamatsu, Japan |
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| Abstract |
| Abstract A 41-year-old woman, who had been diagnosed with rheumatoid arthritis (RA), was admitted because of proteinuria, and rheumatoid and gastrointestinal symptoms just 1 year after onset. Renal biopsy revealed marked amyloid deposits of AA (amyloid A)-type. Genotyping of serum amyloid A (SAA) showed that she was homozygous for SAA1%. Combined treatment with cyclophosphamide and prednisolone led to remission of both RA disease activity and proteinuria. Since the renal dysfunction arose from amyloidosis, arrested renal deterioration and a remission of proteinuria would result from a reduction of amyloid deposits. Therefore, early usage of immunosuppresive therapy such as a combined treatment with these two medicines would be useful against systemic amyloidosis secondary to RA, even if the patient has the risky SAA1%/% genotype. |
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| Key words |
| Key words Rheumatoid arthritis ・ SAA1&ggr;/&ggr; amyloidosis ・ Immunosuppressive therapy |
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