[Amyloidosis complicating psoriatic arthritis]

Abstract

Background: Secondary AA amyloidosis is a classical complication of rheumatismal or chronic infectious diseases. Psoriasis is a rare cause of secondary amyloidosis with only around thirty cases reported in the literature.

Case report: A 62 year-old man exhibited cutaneous lesions of psoriasis for six years complicated by articular involvement over the past year. The occurrence of an isolated proteinuria revealed renal and hepatic AA amyloidosis. Treatment with methotrexate (Méthrotrexate), enalapril (Renitec) and colchicine (Colchicine) was initiated and led to a stabilization of the proteinuria for two years.

Discussion: In psoriatic patients, secondary amyloidosis mainly complicates the arthritic diseases of prolonged progression. Our case report is original in the rapid onset of amyloidosis after the first articular signs. The clinical manifestations of secondary amyloidosis are related to renal or gastrointestinal involvement. Prognosis is usually poor. Treatment of secondary amyloidosis is difficult and relies on systemic treatment. Colchicine may be helpful.