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AB0777 Characteristics of amyloid a deposition in psoriatic arthropathy and in rheumatoid arthritis – a comparative postmortem clinicopathologic study of 161 rheumatoid and 12 psoriatic arthritis patients
  1. M Bély1,
  2. Ά Apáthy2
  1. 1Department of Pathology, Policlinic of the Order of the Brothers of Saint John of God
  2. 2Department of Rheumatology, St. Margaret Clinic Budapest, Budapest, Hungary


Background The aim of this study was to determine the prevalence and extent of amyloid A deposition on different tissue structures in various organs of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients.

Methods AAa was detected in 34 (21.1%) (females: 29, average age: 64.3 years, range: 83–32, onset of RA: 48.6, average disease duration: 15.7 years; males: 5, average age: 51.2 years at death, range: 88–19, onset of RA: 41.3, average disease duration: 14.8 years) of 161 RA, and in 2 (16%) female: 2, average age: 57.5 years, range: 63–52, onset of PsA: 47.5, average disease duration: 11.0 years) of 12 PsA patients.

RA and PsA were diagnosed clinically according to the criteria of the American College of Rheumatology (ACR) [1,2].

Amyloid deposits on different tissue structures [arteriole, small artery, medium size artery, venule, small vein, medium size vein, interstitial collagen fiber, reticulin fiber (collagen IV), basal laminas, nerve, renal glomerulus] of 6 organs [heart, lungs, liver, kidney, skin and brain] were determined histologically. The extent of amyloid A deposits was evaluated by semi-quantitative, visual estimation on a 0 to 3 plus scale, based on the number of involved tissue structures per light microscopic field [3].

The prevalence and extent of amyloid A deposits on different tissue structures were compared by Student (Welch) t-probe.

Results The average prevalence (in %) and the average extent of amyloid A deposits (absolute value) on different tissue structures of analyzed 6 organs in RA and PsA patients are summarized in Table.

Conclusions The difference between average prevalence (p<0.388) and average amount (p<0.444) of amyloid A deposits/structures in RA and PsA patients was not significant.

The prevalence and extent of amyloiod A deposits on different tissue structures of analyzed organs changed parallel in RA or PsA patients except for collagen IV and interstitial collagen.

The reverse prevalence and extent of amyloid A deposits on collagen IV and interstitial collagen fibers between RA or PsA patients may be due to structural (qualitative) changes of collagen IV resulting in its increased affinity of amyloid A in PsA patients. Qualitative change of collagens in systemic sclerosis patients has been demonstrated [4].


  1. Arnett FC et al: Arthritis Rheum. 1988; 31(3):315–24. PMID: 3358796.

  2. Helliwell PS, Taylor WJ: Classification and diagnostic criteria for psoriatic arthritis. Ann Rheum Dis 2005;64:ii3-ii8 doi:10.1136/ard.2004.032318.

  3. Bély M, Apáthy Άgnes: Clinical pathology of rheumatoid arthritis. 1–440 pp. Akadémiai Kiadό, Budapest 2012

  4. Istok R et al: Pyridinoline in fibrotized tissues of patients with systemic sclerosis. Annals Rheum Dis 1999; 58(Suppl. 1):192.


Disclosure of Interest None declared

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