SECONDARY AMYLOIDOSIS IN ANKYLOSING-SPONDYLITIS - A SYSTEMATIC SURVEYOF 137 PATIENTS USING ABDOMINAL FAT ASPIRATION

Objective, To assess the frequency and clinical significance of amyloi d deposits in abdominal fat in patients With ankylosing spondylitis (A S). Methods. Abdominal subcutaneous fat aspiration (ASFA) by fine need le was performed in 137 unselected patients with AS of more than 5 yea rs of disease evolution, A followup study was done of patients with am yloidosis in the abdominal fat (ASFA positive test) to evaluate the de velopment of clinical amyloidosis. Results, in 10 (9M/1F) patients wit h AS, the ASFA revealed amyloid deposits (prevalence of 7%). Patients with AS and an ASFA+ test were older and had more active and severe di sease than those without AS. Only 2 ASFA positive test patients had cl inical amyloidosis at the time of the test, After a followup period of 2-10 yrs (mean 5.4 +/- 3.2 yrs), 3 more patients developed symptomato logy due to amyloidosis. All 5 patients With clinical amyloidosis show ed nephropathy, and proteinuria was found in each, The remaining patie nts did not develop clinical amyloidosis during followup, Conclusion. Amyloid deposits in abdominal fat are not a rare finding In AS. A sign ificant proportion of these patients do not develop clinical amyloidos is after a followup of several years. Thus, an ASFA + test in patients with AS is not always associated with a poor prognosis at least in th e short term, although longer followup is required.