SECONDARY AMYLOIDOSIS IN PATIENTS WITH RHEUMATOID-ARTHRITIS - DIAGNOSTIC AND PROGNOSTIC VALUE OF GASTRODUODENAL BIOPSY

Upper gastrointestinal endoscopy was performed in patients with rheuma toid arthritis (RA) during the period 1989-1991, and biopsy specimens were obtained from the stomach and from the duodenum for examining amy loid deposits. Among 407 patients, gastrointestinal amyloidosis was co nfirmed in 54 (13.3%). Twenty-two patients were regarded as having sli ght amyloid deposits, while 32 patients were categorized as having mar ked amyloid deposits. The incidence of clinical manifestations suggest ive of systemic amyloidosis was more frequent in the marked deposits g roup than in the slight deposits group (47% vs 14%, P < 0.05). Among t he patients who died of manifestations associated with amyloidosis, th e survival period following endoscopy was shorter in the marked deposi ts group than in the slight deposits group. These findings suggest tha t gastroduodenal biopsies may be useful for diagnosing secondary amylo idosis and that the degree of amyloid deposits seems to be correlated with the clinical manifestations of RA.