Amyloidosis in an Internal Medicine Department: 12 Years of Experience

Abstract

Background: Amyloidosis is characterized by extracellular deposition
of insoluble protein subunits which lead to dysfunction of
the targeted organs. The amyloidosis AL (primary) and AA (secondary)
are the most common forms of the disease.
Material and Methods: Retrospective study of patients diagnosed
with amyloidosis that were admitted from 2000 to 2012 in
an Internal Medicine department.
Results: A total of 26 patients were obtained, 57.7% with AL
amyloidosis and 42.3% with AA amyloidosis. AL amyloidosis:
53.3% were women and the mean age was 68.5 years. The diagnosis
was made primarily by renal biopsy (46.7%). Half (53.3%)
had multiple myeloma, 20% monoclonal gammopathy, 20% isolated
AL amyloidosis and 6.7% non-Hodgkin´s lymphoma. The
major manifestations were renal (66.7%), cardiac (46.7%) and
gastrointestinal (26.7%). Most had renal insufficiency (86.7%)
and proteinuria (93.3%). More than half (66.7%) died. AA amyloidosis:
the majority were female (63.6%) and the mean age 59.1
years. The diagnosis was performed by renal biopsy in 63.6%.
About half (45.5%) had rheumatoid arthritis (RA) and idiopathic AA
amyloidosis was diagnosed in 27.3%. The main manifestations
were renal (90.9%), cardiac (27.3%) and gastrointestinal (27.3%).
All patients had proteinuria and 81.8% had kidney failure. Four
patients (36.4%) started dialysis and 54.5% died.
Conclusion: Amyloidosis is a rare disease that affects middle-
aged individuals of both genders. It can be diagnosed by
biopsy of affected organs. It produces various systemic disorders,
with special emphasis on proteinuria and kidney failure, leading to
end-stage renal disease and death in a significant percentage of
patients.