[Secondary amyloidosis in chronic polyarthritis].

M Bély
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Abstract

Systemic secondary amyloidosis was a post-mortem finding recorded from 24% of patients with classical chronic polyarthritis. In 80 to 100% of all cases, amyloidosis was present in heart, thyroid gland, kidneys, adrenal gland, pancreas, spleen, and gastro-intestinal canal. It was recordable, in 50 to 70% of all cases, from liver, aorta, lungs, and lymph nodes. Nerves, muscles, skin, and synovial membrane were less often affected (10 to 40% of all cases). No amyloidosis was recorded at all from the brain. Amyloid depositions differed greatly in intensity by organs. The most massive deposits were found in the gastrointestinal tract, kidneys, adrenal glands, thyroid gland, and spleen. Amyloid depositions were moderate in heart, pancreas, lungs, and liver. They were extremely low in lymph nodes, muscles, nerves, synovial membrane, and skin. The author assumes amyloid deposition to be associated with increase in arterial or venous concentrations of circulating amyloid precursors. Frequency and intensity of amyloid depositions in different organs may be linked to blood supply to the latter. The higher the minute volume of a given organ, the more strongly pronounced is the amyloidosis in it. In the context of amyloidogenesis, consideration should be given, as well, to locally delimited factors, such as organ motility.

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[慢性多发性关节炎继发性淀粉样变]。
系统性继发性淀粉样变性是24%的典型性慢性多关节炎患者的死后发现。在所有病例中,淀粉样变出现在心脏、甲状腺、肾脏、肾上腺、胰腺、脾脏和胃肠道中,占80%至100%。在所有病例中,有50%至70%的病例可记录到肝、主动脉、肺和淋巴结。神经、肌肉、皮肤和滑膜较少受影响(占所有病例的10 - 40%)。脑部未见淀粉样变。不同器官淀粉样蛋白沉积的强度差别很大。最大量的沉积物见于胃肠道、肾脏、肾上腺、甲状腺和脾脏。淀粉样蛋白在心脏、胰腺、肺和肝脏均有中度沉积。淋巴结、肌肉、神经、滑膜和皮肤的含量极低。作者假设淀粉样蛋白沉积与动脉或静脉循环淀粉样蛋白前体浓度的增加有关。不同器官中淀粉样蛋白沉积的频率和强度可能与后者的血液供应有关。某一器官的微小体积越高,其淀粉样变就越明显。在淀粉样变发生的背景下,也应考虑局部划定的因素,如器官运动性。
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