AMYLOIDOSIS COMPLICATING TUBERCULOSIS—DIAGNOSIS, PROGNOSIS AND TREATMENT

Abstract

The incidence of amyloidosis in a group of 143 autopsied tuberculous patients was 39%. A series of 79 cases of amyloidosis were carefully studied. The chief clinical and laboratory findings were: hepatomegaly, edema, decreased plasma protein and A-G ratio, elevated blood cholesterol and proteinuria with casts. Several aspects of the interpretation and technic of the congo red test are discussed; 100% absorption of the dye by tissues, within 1 hr., is indicative of amyloidosis. Albuminuria and casts anteceded 100% congo red retention in about 1/3 of a group of 37 cases. Almost 90% of cases were dead within 2 yrs. after development of amyloidosis. 30 patients received treatment for 6 mos.-3 yrs. for amyloidosis[long dash]the basic oral therapy was high protein diet, Fe and dilute HC1; 23 also received parenteral liver therapy. Definite objective improvement noted only in 4 cases who had arrested tuberculous disease. No evidence of anatomical regression of amyloidosis in 5 autopsied cases.