Severe autonomic neuropathy in amyloidosis secondary to rheumatoid arthritis

Autonomic neuropathy, although reported to occur in 15% of patients with AL primary) amyloidosis, is extremely rare in AA (secondary) amyloidosis. We report a patient with amyloidosis secondary to rheumatoid arthritis in whom autonomic neuropathy resulted in severe and disabling orthostatic hypotension. Extensive amyloid deposits were found throughout the autonomic nervous system.