AMYLOIDOSIS IN CHRONIC ATROPHIC ARTHRITIS

Abstract

This is the report of a case of severe chronic atrophic arthritis of 6 yrs. duration and with involvement of practically all of the joints of the body which was treated with 136 weekly injs. of Crowe''s vaccine subcut. in doses varying from 1,000 to 15,000 organisms/wk. during the last 3 yrs. of the patient''s life. Shortly before death in coma, the urine showed a sp. gr. of 1.011, four plus albumin and many red blood cells. The red blood count was 3,200,000, the blood urea N was 180 mg., creatinine was 6 mg. Autopsy revealed marked amyloidosis of the liver, spleen, and both kidneys. The usual causes of secondary amyloidosis, such as extensive tuberculosis or suppurative disease, were not found in this case. Chronic atrophic arthritis has not been considered as a cause of amyloidosis. It seems possible in this case that amyloidosis was related to the prolonged treatment with streptococcal vaccine subcutaneously.