Secondary Amyloidosis of the Kidney as a Complication of Rheumatological Diseases
I. interní klinika VFN
Čes. Revmatol., , 2000, No. 4, p. 142-147.
Secondary (reactive) amyloidosis is a not very rare complication of chronic rheumatological disea-ses such as rheumatoid arthritis (RA), juvenile chronic arthritis (JCA), ankylosing spondylytis (AS).In addition to elevated levels of circulating SAA precursors a number of other factors participatesin the development of the disease, incl. cytokines and growth factors. Renal affection is frequentand is a serious cause of morbidity and mortality of these patients. Severe nephrotic syndrome isencountered, impaired renal functions – glomerular as well as tubular. Treatment of patients withrenal affections is not sufficiently effective and its results are very unsatisfactory. In JCA adminis-tration of chlorambucil is recommended in particular, in RA and AS chlorambucil, cyclophospha-mide, azathioprin. Long-term treatment is essential and side-effects must be foreseen. Perspectivesare symptomatic treatment, i.e. renal transplantation, or causal treatment, i.e. bone marrowtransplantation.
amyloidosis of the kidneys, amyloid, rheumatoid arthritis, juvenile chronic arthritis,ankylosing spondylytis, nephrotic syndrome
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