Ryan J G, Dorman A M, O'Connell P G
Dept of Rheumatology, Beaumont Hospital, Dublin.
Ir J Med Sci. 2006 Apr-Jun;175(2):81-2. doi: 10.1007/BF03167957.
Amyloidosis is an extremely rare complication of psoriatic arthritis (PsA) and is associated with a poor prognosis. We report a case of amyloidosis secondary to severe PsA in a young patient and the course of his disease over a 13-year period of aggressive immunosuppression.
Diagnosis of renal amyloidosis was made on biopsy: multi-agent immunosuppressive therapy was continued with stabilisation of renal function.
Marked deterioration in renal function subsequently occurred following a reduction in cyclosporin A (CyA) dose and repeat biopsy confirmed worsening amyloidosis.
This case report emphasises the need for aggressive control of the inflammatory response in secondary amyloidosis.
淀粉样变性是银屑病关节炎(PsA)极为罕见的并发症,且与预后不良相关。我们报告了一例年轻患者继发于重度PsA的淀粉样变性病例,以及其在13年积极免疫抑制治疗过程中的疾病历程。
通过活检诊断为肾淀粉样变性;继续采用多药联合免疫抑制治疗,肾功能得以稳定。
在环孢素A(CyA)剂量减少后,肾功能随后出现显著恶化,重复活检证实淀粉样变性加重。
本病例报告强调了积极控制继发性淀粉样变性炎症反应的必要性。