R. Myllykangas-luosujarvi et al., Amyloidosis in a nationwide series of 1666 subjects with rheumatoid arthritis who died during 1989 in Finland, RHEUMATOLOG, 38(6), 1999, pp. 499-503
Objectives. Virtually all studies dealing with the occurrence of amyloidosi
s in subjects with rheumatoid arthritis (RA) have been based on selected se
ries collected from university clinics. The purpose of the study was to obt
ain information on the true prevalence of amyloidosis and the role of amylo
idosis as a cause of death.
Methods. The study included all 1666 subjects (480 men and 1186 women) who
had died in 1989 and had been entitled under the national sickness insuranc
e scheme to receive specially reimbursed medication for RA.
Results. Amyloidosis was regarded as an immediate cause or an intervening a
ntecedent cause of death in 64 cases (3.8%) and as a contributory cause of
death in 33 cases (2%), corresponding to a prevalence of 5.8%. Amyloidosis
had been diagnosed during life in 89 instances and was detected at autopsy
in eight instances. Twenty-three (4.8%) of the subjects were men and 74 (6.
2%) were women (P = 0.25). Compared with the remaining subjects in the stud
y series, the lifespan of the subjects with amyloidosis was shortened by 7.
7 yr.
Conclusions. The prevalence of amyloidosis was lower than apparent from mos
t earlier studies. Monitoring information derived from the Finnish sickness
insurance system is a useful way of following trends in the occurrence of
amyloidosis complicating RA.