Abstract
The patient, a 56-year-old female with rheumatoid arthritis (RA) associated with secondary amyloidosis was reported. She was treated for RA (stage IV, class 3) for four years in our hospital. On December 8, 1981, she was admitted with epigastralgia, nausea and vomiting. On physical examination, slight clouding of consciousness and remarkably dry skin were noted. Laboratory data showed a severe decrease in total protein and an increase in serum BUN and serum creatinine. We suspected malignant RA and treated the patient with prednisolone and antibiotics. But renal failure ensued, and the consciousness level declined. She ultimately died of pneumonia. The chief autopsy findings were as follows. Pathological diagnosis : RA associated with secondary amyloidosis.
A) RA : Fibrin exudation over the surface of the fibrous synovial membrane with lymphoid cell infiltration.
B) Secondary amyloidosis : Major organs involved kidney, spleen, heart, thyroid gland, liver, pancreas, stomach, intestine, colon. It is very rare that major organs are examined systemically and reveal a very acute onset as in this case.
