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FRANCESCO CAPPELLO

AMYLOIDOSIS AND INFLAMMATORY BOWEL DISEASE: FACT OR MITH?

  • Autori: Sinagra,E; Ciofalo, M; Tomasello,G; Cappello,F; Morreale;GC; Amvrosiadis,G; Damiani,P; Damiani,F; Pompei,G; Rizzo,AG; Canale,C; Mastrocinque,G; Carini,F; Raimondo D
  • Anno di pubblicazione: 2017
  • Tipologia: Articolo su rivista (Articolo in rivista)

Abstract

Inflammatory Bowel Disease (IBD), which includes both Crohn's Disease (CD) and Ulcerative Colitis (UC), is a chronic idiopathic inflammatory disorder affecting the gastrointestinal tract. Extraintestinal manifestations (EIM) are common in patients with IBD, and occur in 6-47% of patients with CD or UC. EIM can involve organs other than the gastrointestinal tract such as skin, eyes, joints, biliary tract and kidneis. Renal and urinary involvement particularly occurs in 4-23% of patients with IBD. Among the renal complications of IBD, seconfary amyloidosis (AA-type, AAA) is a rare but serious complication. renal amyloidosis has been proven to be the most common lethal manifestation of IBD-associated amyloidosis, since renal involvement rapidly leads to end-stage renal failure. A few studies suggest that AAA is more prevalent in CD than in UC, mainly occurring in male patients with an extensive long-lasting and penetrating ddisease pattern. The therapeutic approaches of IBD-associated AAA are based both on control of the chronic inflammatory process that causes the production and storage of serum amyloid A (SAA), which is a precursor of the amyloid, as well as on destabilizing amyloid fibrils so that they can no longer maintain their pleated sheet configuration; however, in patients with end-stage renal disease, the only therapeutic options still available are hemodyalisis and renal transplantation. Whether effective treatment exists for AAA remain controversial.

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