Clinical regression of amyloid nephropathy in a patient with rheumatoid arthritis. A case report

A 22-year-old woman with active seronegative rheumatoid arthritis responded to intramuscular gold but developed proteinuria which settled when this therapy was stopped. Proteinuria recurred after 2 weeks of penicillamine therapy but settled when this regimen was stopped. Six months later she developed a nephrotic syndrome and rectal and renal biopsies showed evidence of amyloidosis. She was treated with chlorambucil for 1 year and the disease activity was well controlled. There was regression of the nephrotic syndrome and her serum albumin and renal function are normal 6 years later.