Systemic amyloidosis in Uganda. An autopsy study.

Seventy-nine cases of systemic amyloidosis were found in a survey of the autopsy records of 23 years at Mulago Hospital, Kampala, an incidence of 0-57%. The variable world incidence is described. Fifty-two cases were secondary to chronic inflammation and in 27 cases no underlying disease was apparent. Primary amyloid is more common than might be expected, and appears to occur at a younger age to that seen in developed countries. The organ distribution of primary and secondary amyloid is similar, with heavy renal involvement. These findings might be explained by chronic antigenic stimulation enhanced by impaired thymic dependent immunity. Secondary amyloidosis is not as common as would be anticipated in view of the high incidence of chronic inflammatory disease.