Abstract
Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.
Original language | English |
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Article number | 100504 |
Journal | Kidney Medicine |
Volume | 4 |
Issue number | 8 |
DOIs | |
Publication status | Published - Aug 2022 |
Bibliographical note
Funding Information:Jordan Thorne, MD, David Clark, MD, Laurette Geldenhuys, MD, Keigan More, MD, Amanda Vinson, MD, and Karthik Tennankore, MD, Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Received January 25, 2022 as a submission to the expedited consideration track with 3 external peer reviews. Direct editorial input from the Editor-in-Chief. Accepted in revised form April 29, 2022.
Funding Information:
Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests.
Publisher Copyright:
© 2022 The Authors
ASJC Scopus Subject Areas
- Internal Medicine
- Nephrology
PubMed: MeSH publication types
- Journal Article
- Review