Secondary, AA, Amyloidosis

Rheum Dis Clin North Am. 2018 Nov;44(4):585-603. doi: 10.1016/j.rdc.2018.06.004. Epub 2018 Sep 7.


Secondary, AA, amyloidosis is a rare systemic complication that can develop in any long-term inflammatory disorder, and is characterized by the extracellular deposition of fibrils derived from serum amyloid A (SAA) protein. SAA is an acute-phase reactant synthetized largely by hepatocytes under the transcriptional regulation of proinflammatory cytokines. The kidney is the major involved organ with proteinuria as first clinical manifestation; renal biopsy is the commonest diagnostic investigation. Targeted anti-inflammatory treatment promotes normalization of circulating SAA levels preventing amyloid deposition and renal damage. Novel therapies aimed at promoting clearance of existing amyloid deposits soon may be an effective treatment approach.

Keywords: AA amyloidosis; Autoinflammatory syndrome; Congo red staining; Rheumatoid arthritis; SAA1 gene; SAP scintigraphy; Serum amyloid A; Systemic amyloidosis.

Publication types

  • Review

MeSH terms

  • Amyloidosis* / diagnosis
  • Amyloidosis* / etiology
  • Amyloidosis* / metabolism
  • Anti-Inflammatory Agents / pharmacology*
  • Humans
  • Inflammation* / complications
  • Inflammation* / immunology
  • Kidney / metabolism
  • Kidney / pathology
  • Serum Amyloid A Protein / metabolism*
  • Therapies, Investigational / methods
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Serum Amyloid A Protein