Internal Medicine

P1: SBT

0521779407-03 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:6

114 Amyloidosis

Prognosis

■survival dependent on organ involvement

■survival less than 6 months from onset of heart failure

■prolongation of survival possible with autologous stem cell trans-

plant

Secondary Amyloidosis (AA)

■Treatment options

■treat underlying inflammatory/infectious etiology.

■colchicine: for FMF and inflammatory conditions

■chlorambucil and cyclophosphamide

■Side Effects & Contraindications

■colchicine

➣side effects: GI toxicity, myelosuppression

➣contraindications: active infections

■cytotoxic drugs

➣side effects: myelosuppression, infectious complications

➣contraindications: active infections

Follow-up

During Treatment

■CBC q 2–3 weeks

Routine

■assessment of underlying condition as indicated

Complications & Prognosis

Complications

■progression of infectious or inflammatory condition

■renal failure

Prognosis

■dependent on cause of AA

■prevention of AA with FMF using colchicine

Familial Amyloidosis (ATTR)

■supportive care based on organ involvement and clinical symptoms

■Treatment options

■liver transplantation considered definitive therapy

Follow-Up

Routine

■assessment of underlying condition as indicated