Sjögren's syndrome and localized nodular cutaneous amyloidosis: coincidence or a distinct clinical entity?

Arthritis Rheum. 2008 Jul;58(7):1992-9. doi: 10.1002/art.23617.

Abstract

Objective: To report 8 patients with Sjögren's syndrome (SS) and localized nodular cutaneous amyloidosis and to examine serologic and immunohistologic findings that may link the 2 diseases.

Methods: The databases for 3 amyloidosis centers were searched for patients with localized nodular cutaneous amyloidosis and SS. Eight patients with this combination were identified, and clinical, serologic, and histologic parameters were retrospectively evaluated.

Results: Among the 8 patients with a clinical diagnosis of SS, 6 fulfilled the American-European Consensus Group criteria for SS. All of the patients were women in whom SS had been diagnosed at a median age of 47 years (range 30-61 years) and amyloid had been diagnosed at a median age of 60 years (range 42-79 years). The presence of the immunoglobulin light chain type of amyloid (AL amyloid) was confirmed in 4 patients. In 3 of these 4 patients as well as 2 other patients, a light chain-restricted plasma cell population was observed near the amyloid deposits. Progression to systemic amyloidosis was not observed in any patient during a median followup of 3.5 years.

Conclusion: SS should be considered in patients with cutaneous amyloidosis. The combination of cutaneous amyloidosis and SS appears to be a distinct disease entity reflecting a particular and benign part of the polymorphic spectrum of lymphoproliferative diseases related to SS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amyloid / blood*
  • Amyloidosis / blood*
  • Amyloidosis / complications
  • Amyloidosis / pathology
  • Female
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Sjogren's Syndrome / blood*
  • Sjogren's Syndrome / complications
  • Sjogren's Syndrome / pathology
  • Skin Diseases / blood*
  • Skin Diseases / complications
  • Skin Diseases / pathology

Substances

  • Amyloid
  • amyloid protein AL