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Causes
By Mayo Clinic staffDoctors classify amyloidosis into three major forms:
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Primary amyloidosis. This most common form of amyloidosis can affect many areas, including your heart, kidneys, liver, spleen, nerves, intestines, skin, tongue and blood vessels. Primary amyloidosis isn't associated with other diseases — except for multiple myeloma, a form of bone marrow cancer, in a minority of cases.
The exact cause of primary amyloidosis is unknown, but doctors do know that the disease begins in your bone marrow. In addition to producing red and white blood cells and platelets, your bone marrow makes antibodies — proteins that protect you against infection and disease. After antibodies serve their function, your body breaks them down and recycles them. Amyloidosis occurs when cells in the bone marrow produce antibodies that can't be broken down. These antibodies then build up in your bloodstream. Ultimately, they leave your bloodstream and can deposit in your tissues as amyloid, interfering with normal function.
- Secondary amyloidosis. This form occurs in association with chronic infectious or inflammatory diseases, such as tuberculosis, rheumatoid arthritis or osteomyelitis, a bone infection. It primarily affects your kidneys, spleen, liver and lymph nodes, though other organs may be involved. Treatment of the underlying disease may help stop progression of this form of amyloidosis.
- Hereditary (familial) amyloidosis. As the name implies, this form of amyloidosis is inherited. This type often affects the liver, nerves, heart and kidneys.
- Seldin DC, et al. Amyloidosis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2863105. Accessed June 11, 2009.
- Amyloidosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec12/ch160/ch160a.html. Accessed June 12, 2009.
- Gertz MA, et al. Amyloidosis. Best Practice & Research Clinical Haematology. 2005;18:709.
- Amyloidosis and kidney disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://kidney.niddk.nih.gov/kudiseases/pubs/Amyloidosis/. Accessed June 12, 2009.
- Gorevic PD. An overview of amyloidosis. http://www.uptodate.com/home/index.html. Accessed June 12, 2009.
- Dember LM. Modern treatment of amyloidosis: Unresolved questions. Journal of the American Society of Nephrology. 2009;20:469.
- Merlini G. Amyloidosis: Is a cure possible? Annals of Oncology. 2008;19(suppl):iv63.
- Jaccard A. High-dose melphalan versus melphalan plus dexamethasone for AL amyloidosis. New England Journal of Medicine. 2007;357:1083.
