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The two most common types of systemic amyloidosis are AL (primary amyloidosis, associated with a monoclonal plasma cell disorder) and AA (secondary to chronic inflammatory disorders). Researchers at the U.K. National Amyloidosis Centre describe the natural history of AA amyloidosis in 374 patients referred during a 15-year period (median age at diagnosis, 50).
The underlying chronic inflammatory disorder was arthritis in 60% of patients and chronic infection in 15%. At baseline, 97% of patients had renal involvement with either proteinuria or elevated serum creatinine. On serum amyloid P (SAP) scintigraphy — an imaging technique that identifies amyloid deposits — 23% of patients had hepatic involvement that was generally asymptomatic. Only o…