Medically reviewed and verified by Kate Burke, MD, MHA
Of the various types of amyloidosis, AA amyloidosis comes about because of another long-term illness. This is often chronic inflammation or infection. Like other forms of amyloidosis, this type can affect different organs in different ways. Understanding how and why this disease progresses is the best way to manage your health.
How it Develops
This condition involves a protein called serum amyloid A (SAA), which is produced by the liver. When you have chronic inflammation, the liver produces more SAA protein. Chronic inflammation is long-term swelling and irritation in the body caused by ongoing illness or infection. Typically, after the inflammation or illness subsides, the body breaks down this protein. However, if the inflammation continues for a prolonged period, a fragment of the SAA protein known as AA protein can start to accumulate in tissues. These accumulations, called amyloid deposits, can interfere with the normal function of organs. This in turn leads to serious health issues.
Common Causes
AA amyloidosis usually shows up in people with severe, long-standing inflammatory conditions. These conditions include rheumatologic diseases such as rheumatoid arthritis, juvenile arthritis, ankylosing spondylitis, and psoriatic arthritis. Gastrointestinal inflammatory diseases like Crohn’s disease and ulcerative colitis are also common causes. Chronic infections like tuberculosis, chronic lung infections, osteomyelitis (a bone infection), and infections associated with cystic fibrosis or HIV/AIDS can lead to AA amyloidosis as well. Certain hereditary disorders, like familial mediterranean fever (FMF) and tumor necrosis factor receptor-associated periodic syndrome (TRAPS), can also lead to AA amyloidosis.
Symptoms
AA amyloidosis can affect different organs. Most commonly it impacts the kidneys. A recent study of patients with the condition found that it led to kidney failure in 44% of cases. The symptoms to watch for depend on which organs are affected. Here is an overview of the most common.
Kidneys
- Proteinuria (protein in the urine)
- Swelling in the ankles and legs
- High blood pressure
- Kidney failure
Liver and Spleen
- Enlarged organs
- Issues with liver function
Digestive System
- Diarrhea
- Constipation
- Stomach pain
Heart
- Heart failure
- Irregular heartbeat
Thyroid
- Enlarged thyroid gland
Diagnosis and Treatment
There are a few steps doctors can take to diagnose AA amyloidosis. Doctors will first look at the patient's long-term illnesses and symptoms to get a clear picture. Two biopsies can be performed to check for the presence of amyloid proteins. A fat pad biopsy is when providers take a small sample of abdominal fat from just under your skin. An organ biopsy is when the sample is taken from the affected organ. Further tests may be done to distinguish between AA and AL amyloidosis. AL amyloidosis is more aggressive but shares symptoms with AA.
The primary goal of treatment for AA amyloidosis is to control the underlying disease causing the inflammation. By doing so, the production of the harmful protein is reduced. This can prevent further amyloid deposits. Treatment options include medications to manage inflammation and control the primary disease, such as anti-inflammatory drugs and antibiotics for infections. Lifestyle changes, including a balanced diet, stress management, and regular exercise, can also support overall health.
By managing the underlying condition and making healthy lifestyle choices, people with AA amyloidosis can improve their quality of life and reduce complications. Always consult with your healthcare provider for personalized advice and treatment plans.
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