Abstract
We report on a patient with rheumatoid arthritis (RA) who developed marked gastrointestinal symptoms after the start of dialysis for the treatment of systemic amyloidosis secondary to RA.
The patient was a 40-year-old woman who had been suffering from RA for about 10 years before she came to show increased urinary protein and renal dysfunction.
After the start of dialysis, gastrointestinal symptoms such as nausea and vomitting were persistent, and finally she developed repeated melena. Amyloidosis was suspected after gastro-and colono-fiberoscopy.
The bleeding could not be stopped, and one month after the start of dialysis, she died. Postmortem histological examination confirmed a definite diagnosis of amyloidosis type AA.
The initial signs of renal amyloidosis secondary to RA are thought to include an abrupt increase in urinary protein and renal hyofunction. The treatment should be tried as soon as possible after the diagnosis of amyloidosis is established by an early renal biopsy.
