Secondary amyloidosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2] Sahar Memar Montazerin, M.D.[3]

Overview

In amyloidosis, insoluble fibrils of amyloid are deposited in organs, causing organ dysfunction and eventually death. Patients with amyloidosis may eventually suffer from heart failure, nephrotic syndrome, hepatomegaly and peripheral neuropathy. In primary amyloidosis, the survival rate depends upon the type of organ involvement and the hematological response to treatment.

In amyloidosis, insoluble fibrils of amyloid are deposited in the organs, causing organ dysfunction and eventually death.^[1]^[2]
Patients with amyloidosis may eventually suffer from heart failure, nephrotic syndrome, hepatomegaly and peripheral neuropathy.

In patients with amyloidosis, the most frequent complications include:^[3]

Prognosis is not good and 5-years survival rate is 51.3%.^[4]
Following factors are associated with higher rates of mortality:
- Older age
- Male gender
- lower BMI
- Lower GFR
- Lower serum albumin and calcium
- Higher levels of phosphor with intact parathyroid hormone
It has been reported that, survival rate is not affected by the underlying etiology.^[5]

↑ Baker KR, Rice L (2012). "The amyloidoses: clinical features, diagnosis and treatment". Methodist Debakey Cardiovasc J. 8 (3): 3–7. PMC 3487569. PMID 23227278.
↑ Khan MF, Falk RH (November 2001). "Amyloidosis". Postgrad Med J. 77 (913): 686–93. PMC 1742163. PMID 11677276.
↑ Jerzykowska S, Cymerys M, Gil LA, Balcerzak A, Pupek-Musialik D, Komarnicki MA (2014). "Primary systemic amyloidosis as a real diagnostic challenge - case study". Cent Eur J Immunol. 39 (1): 61–6. doi:10.5114/ceji.2014.42126. PMC 4439975. PMID 26155101.
↑ Ahbap E, Kara E, Sahutoglu T, Basturk T, Koc Y, Sakaci T, Sevinc M, Akgol C, Ucar ZA, Kayalar AO, Bayraktar F, Ozagari AA, Unsal A (July 2014). "Outcome of 121 patients with renal amyloid a amyloidosis". J Res Med Sci. 19 (7): 644–9. PMC 4214024. PMID 25364365.
↑ Ayar Y, Ersoy A, Oksuz MF, Ocakoglu G, Vuruskan BA, Yildiz A, Isiktas E, Oruc A, Celikci S, Arslan I, Sahin AB, Güllülü M (2017). "Clinical outcomes and survival in AA amyloidosis patients". Rev Bras Reumatol Engl Ed. 57 (6): 535–544. doi:10.1016/j.rbre.2017.02.002. PMID 29173691.