• Ju-Yang Jung, Young-Bae Kim, Ji-Won Kim, Chang-Hee Suh, and Hyoun-Ah Kim.
• Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea.
• Medicine (Baltimore). 2021 Aug 13; 100 (32): e26843e26843.

IntroductionSecondary amyloidosis is a rare complication of rheumatoid arthritis (RA) that is histologically characterized by the deposition of amyloid fibrils in target organs, such as the kidneys and gastrointestinal tract. Controlling the inflammatory response is essential to prevent organ dysfunction in amyloid A (AA) amyloidosis secondary to RA, and no clear treatment strategy exists.Patient Concerns And DiagnosisA 66-year-old woman with RA, who had been treated with disease-modifying anti-rheumatic drugs for 1 year, presented with recurrent abdominal pain and prolonged diarrhea. Endoscopy showed chronic inflammation, and colon tissue histology confirmed AA amyloidosis.Interventions And OutcomesAfter tocilizumab therapy was begun, her diarrhea and abdominal pain subsided, and articular symptoms improved. Biologic drugs for RA have been used in patients with secondary AA amyloidosis, including tumor necrosis factor and Janus kinase inhibitors, interleukin 6 blockers, and a T cell modulator. Here, we systematically review existing case reports and compare the outcomes of RA-related AA amyloidosis after treatment with various drugs.ConclusionThe data indicate that biologic drugs like tocilizumab might be treatments of choice for AA amyloidosis secondary to RA.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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