THE DETECTION OF SECONDARY AMYLOIDOSIS IN RHEUMATOID-ARTHRITIS PATIENTS BY MEANS OF ASPIRATION NEEDLE-BIOPSY OF ABDOMINAL SUBCUTANEOUS FAT

81 rheumatoid arthritis patients were regularly and periodically exami ned in rheumatological department of Tartu University Clinic. Dependin g on the presence of amyloid in subcutaneous fat biopsies the patients were divided into two comparable groups: amy loid-positive (group 1 o f 22 patients) and amyloid-negative (group 2 of 59 patients). Between the groups some differences were found: group I patients had more acti ve and severe course of rheumatoid arthritis and higher level of rheum atoid factor and circulating immune complexes in tile sera. Before bio psy secondary amyloidosis was diagnosed in 17.4% of the examinees, bio psy of abdominal subcutaneous fat increased this rate to 27.2% We coul d not ascertain any effect of previous treatment on secondary amyloido sis development except tile connection with long-term use of corticost eroids. The analysis of 10379 autopsies showed that cases of RA with a myloidosis account for 30.9% of all amyloidosis cases. Multiple stepwi se regression analysis determined predisposition factors to secondary amyloidosis as severity of locomotor system involvement, long-term use of corticosteroids, high level of rheumatoid factor and activity of r heumatoid process.