4-(2) アミロイドーシス合併例の治療と予後の対策(シンポジウム関節リウマチの診療 : 最近の進歩)(第584回新潟医学会)

概要

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It is well known that amyloidosis is one of the critical complications which Influences the prognosis of patients with rheumatoid arthritis (RA). We studied seventy-six patients with definite or classical RA who were diagnosed as amyloidosis by biopsy. The average duration of RA prior to the diagnosis of amyloidosis was 15.4 ± 9.4 years. The average period from the diagnosis of amyloidosis to death was 67.4 months. High onset age of amyloidosis was the major factor deter-mining poor survival in these patients (P < 0.001). Additionally, the male gender played a major factor determining poor survival (P < 0.001) . Thirty-eight patients were treated with hemodialysis. Survival in dialysis at 9.8 months was 75 %, at 60.6 months was 50 %, and at 100.0 months was 25 %. Survival of amyloidosis patients without dialysis within the same period was better at 31.8 months with a survival rate of 75 % and at 66.7 months was 50 %, and the difference was not significant. The long-term results were sufficient to encourage us to initiate hemodialysis in patients with end stage renal disease due to reactive amyloidosis associated with RA.
新潟大学の論文
2003-09-10