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Amyloid load in fat tissue reflects disease severity and predicts survival in amyloidosis
Author(s) -
van Gameren Ingrid I.,
Hazenberg Bouke P. C.,
Bijzet Johan,
Haagsma Elizabeth B.,
Vellenga Edo,
Posthumus Marcel D.,
Jager Pieter L.,
van Rijswijk Martin H.
Publication year - 2010
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.20101
Subject(s) - medicine , amyloidosis , amyloid (mycology) , pathology , adipose tissue , aa amyloidosis , al amyloidosis , disease , immunology , antibody , immunoglobulin light chain , familial mediterranean fever
Objective The severity of systemic amyloidosis is thought to be related to the extent of amyloid deposition. We studied whether amyloid load in fat tissue reflects disease severity and predicts survival. Methods We studied all consecutive patients with systemic amyloidosis seen between January 1994 and January 2007 in our tertiary referral center. Congo red–stained abdominal fat smears were graded by 2 observers using a validated semiquantitative scoring system. Disease severity was measured by the total number of major organs involved and the extravascular retention of the serum amyloid P component (EVR 24 ). The association of amyloid load in fat tissue with disease severity and overall survival was studied using multiple regression analysis. Results Two hundred twenty patients were included in the study (120 with AL amyloidosis, 66 with AA amyloidosis, and 34 with ATTR amyloidosis). Amyloid grade in fat tissue was associated with the number of major organs involved and EVR 24 . Female sex turned out to be associated with a higher grade of amyloid in fat tissue than male sex. Amyloid grade in fat tissue was an independent predictor of decreased survival, as were heart involvement, the number of organs involved, AA or AL type of amyloid, and age. Conclusion The amount of amyloid in subcutaneous fat tissue in systemic amyloidosis reflects disease severity, as measured by the number of organs involved and EVR 24 , and predicts decreased survival independent of other well‐known factors.