[Psoriatic arthritis with renal amyloïdosis. A case-report. Review of the literature (author's transl)].

A case of severe psoriatic arthritis with both spinal and peripheral joint involvement is reported. The patient, an HLA B27-positive man, was thirty-one years old at onset. Both antiinflammatory drugs and immunosuppressive agents (chlorambucil followed by azathioprine) were ineffective and the patient became bed-ridden. Thirty-three months after onset a severe nephrotic syndrome developed. Renal biopsy let to diagnosis of secondary renal amyloïdosis. The patient died five months later in spite of chemotherapy with melphalan and prednisone. Autopsy could not be performed. A review of the literature showed twelve other cases of psoriatic arthritis with secondary amyloïdosis. Men are affected more often than women. Twelve years was the average interval between onset of joint involvement and diagnosis of amyloïdosis. In three instances, however, this interval was less than thirtyeight months. Arthritis often included both spinal and peripheral joint involvement. Amyloïdosis was evidenced by a nephrotic syndrome in eight out of twelve cases. Prognosis is poor with a fourteen months average interval between onset of clinical amyloidosis and death.