• Rev Med Interne · Dec 2019

    Case Reports

    [A systemic disease mimicking a rheumatoid arthritis].

    • M Legrand, M Nouvier, L Paulin, B Deschamps, J B Pialat, and F Coury.
    • Service de rhumatologie, hospices civils de Lyon, Centre Hospitalier Lyon Sud, 69495 Pierre-Bénite, France; Université Lyon 1, 69007 Lyon, France. Electronic address: melanie.legrand@chu-lyon.fr.
    • Rev Med Interne. 2019 Dec 1; 40 (12): 831-836.

    IntroductionRare systemic diseases such as amyloidosis can mimic inflammatory rheumatic diseases. Because of their poor prognosis, physicians should rule them out at the onset of inflammatory rheumatism. We report a case of AL amyloidosis misdiagnosed as rheumatoid arthritis.Case ReportA 71-year-old woman was referred for seronegative rheumatoid arthritis, resistant to three biologic therapies. She had an IgA lambda monoclonal gammopathy of undetermined significance (MGUS). The patient subsequently developed glomerular proteinuria. Abdominal fat and accessory salivary glands biopsies revealed amyloid light-chain (AL) amyloidosis. Treatment with bortezomib-cyclophosphamide-dexamethasone, led to complete hematologic, renal and rheumatologic remission. Ten months after treatment interruption, the patient had an articular and hematologic relapse.ConclusionAmyloid light-chain amyloidosis arthropathy is probably underdiagnosed. A review of amyloid arthropathy associated with multiple myeloma found that 33% of patients had been misdiagnosed with rheumatoid arthritis.Copyright © 2019 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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