The analysis of secondary AA-amyloidosis current etiology and its influence on the approaches for diagnosis and treatment

• Published in: Terapevtic̆eskii arhiv Vol. 93; no. 6; pp. 672 - 678
• Main Authors: Rameev, Vilen V., Kozlovskaya, Lidiia V., Rameeva, Anna S., Novikov, Aleksandr V., Barsuk, Mariia V.
• Format: Journal Article
• Language: English; Russian
• Published: "Consilium Medicum" Publishing house 15.06.2021
• Subjects: aa-amyloidosis; autoinflammatory diseases; castleman's disease; mediterranean fever; rheumatoid arthritis; s100a12; saa
• ISSN: 0040-3660; 2309-5342
• DOI: 10.26442/00403660.2021.06.200851

Aim. To investigate an influence of the currently changed etiologic structure of AA-amyloidosis on the diagnosis and treatment tactics. Materials and methods. In 110 patients with АА-amyloidosis followed during full disease duration (1 month 29 years) etiology, clinical manyfestations and approaches to diagnose and treatment of AA-amyloidosis were evaluated. With ELISA levels of amyloid precursor acute phase inflammation reactant SAA and neutrophil activity marker S100A12 were measured. Results. Among the most common causes of AA-amyloidosis at the present stage, in addition to RA (40.3%), a significant place is occupied by a group of diseases with a predominantly autoinflammatory mechanism (53.73%). To confirm the autoinflammatory mechanism of the predisposing disease it is recommended to study a highly sensitive parameter serum protein S100A12. An effective marker of the risk of AA-amyloidosis progression, especially in patients with subclinical activity of inflammatory disease, is a high level of production of amyloidogenic protein-a precursor of SAA.