Autopsy findings are reported of a 51-year-old female patient with a 40-year history of mutilating psoriatic arthritis. As a result of this disease the patient developed reactive amyloidosis (AA-type) with generalized vascular involvement, amyloid kidneys and unusual amyloid goitre. The cause of death was ischaemic left ventricular failure due to massive amyloid deposits in the coronary arteries and left ventricular hypertrophy, the latter resulting from renal hypertension. Thus, amyloidosis and ischaemic heart disease were late complications of the underlying inflammatory disease.