Pulmonary amyoidosis.

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We made clinical, immunologic and histochemical studies of 22 cases of AL type and non-AA type pulmonary amyloidosis, none of which were associated with multiple myeloma and other 2 cases of AA type pulmonary amyloidosis, which were associated with systemic lupus erythematosus. Eighteen cases among them had evidence of systemic deposition of amyloid. The majority of our cases were of AL type or of non-AA type. In the former monoclonal proteins were demonstrated in the serum and/or urine by immunofixation. The latter showed amyloid staining with Congo red which was resistant to potassium permanganate, but had no monoclonal proteins in both the serum and urine.These findings were contrary to the general expectation that chronic pulmonary diseases, such as silicosis, bronchiectasis and lung cancer, are often complicated with AA type amyloidosis.AL type or non-AA type amyloidosis might occur in association with plasma cell dyscrasia following polyclonal responses to chronic diseases. On the other hand, if inflammatory processes stimulating a production of S-AA, a precursor of AA protein, are more prominent, AA type amyloidosis might occur.
日本臨床免疫学会の論文