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MR Vol.10 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.10 No.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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