skip to main content

AA Amyloidosis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateRheumatologyAA AmyloidosisRACP Adult Medicine

A 55-year-old man with long-standing rheumatoid arthritis (25 years) develops proteinuria (4 g/day) and renal impairment. SAA (serum amyloid A) is chronically elevated. Renal biopsy shows Congo red-positive amyloid deposits with AA protein on immunohistochemistry. No paraprotein detected. What is the most likely amyloid type?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — AA amyloidosis

Proteinuria with amyloid deposits staining for AA protein in a patient with chronic inflammatory disease (RA) is AA (secondary/reactive) amyloidosis. AA amyloid is derived from serum amyloid A (an acute phase protein). It predominantly affects kidneys (nephrotic syndrome), liver, spleen, and adrenals. Treatment: control underlying inflammation (aggressive DMARD therapy for RA). No cardiac involvement (distinguishes from AL).

Reference: BSH – 2024 – AA Amyloidosis; EULAR 2024