TY  - JOUR
SP  - 162
VL  - 24
IS  - 3
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
UR  - https://doi.org/10.1080/13506129.2017.1342235
SN  - 1744-2818
JF  - Amyloid: The Journal of Protein Folding Disorders
A1  - Lane, T
A1  - Pinney, JH
A1  - Gilbertson, JA
A1  - Hutt, DF
A1  - Rowczenio, DM
A1  - Mahmood, S
A1  - Sachchithanantham, S
A1  - Fontana, M
A1  - Youngstein, T
A1  - Quarta, CC
A1  - Wechalekar, AD
A1  - Gillmore, JD
A1  - Hawkins, PN
A1  - Lachmann, HJ
TI  - Changing epidemiology of AA amyloidosis: clinical observations over 25 years at a single national referral centre
AV  - public
Y1  - 2017///
EP  - 166
N2  - Objective: Systemic AA amyloidosis is a serious complication of chronic inflammation; however, there are relatively few published data on its incidence. We investigated the changing epidemiology of AA amyloidosis over a 25-year period at a single national referral centre. //

Methods: We conducted a retrospective study of all patients diagnosed with AA amyloidosis who had attended the centre between 1990 and 2014 inclusive. Six hundred and twenty-five patients were studied in three cohorts: C1: 1990?1997; C2: 1998?2006; C3: 2007?2014. //

Results: Mean age at presentation increased from 46 in C1 to 56 in C3 (p?<?.0001). The proportion of South Asian patients increased from 4% in C1 to 17% in C3 (p?=?.0006). Comparison of underlying diseases between C1 and C3 revealed a reduction in patients with juvenile idiopathic arthritis from 25% to 2% (p?<?.0001), but an increase in patients with chronic infection due to intravenous recreational drug use from 1% to 13% (p?<?.0001), and uncharacterized inflammatory disorders from 10% to 27% (p?<.0001). More patients were in end-stage renal failure at presentation in C3 (29%) than C1 (15%) (p?=?.0028). Median age at death was later in C3 (62 years) than C1 (54 years) (p?=?.0012). //

Conclusion: These data suggest both falling incidence and better outcome in AA amyloidosis over a quarter of a century, reflecting advances in therapeutics and overall management of complex chronic disease in an ageing population. AA amyloidosis of uncertain aetiology presents an emerging major problem. Newer techniques such as next-generation sequencing may aid diagnosis and effective treatment, thereby improving overall survival.
ID  - discovery10052925
PB  - TAYLOR & FRANCIS LTD
KW  - AA amyloidosis
KW  -  systemic amyloidosis
KW  -  epidemiology
KW  -  inflammation
KW  -  renal failure
ER  -