Psoriasis Combined with Systemic Amyloidosis: Clinical Observation

DOI: 10.47026/2413-4864-2023-3-116-125

UDC: (616-003.821)-02:616.517-002
BBC: 55.831.9 + 54.101я7-1

Khusainova A.A., Boychev V.A., Kozlov V.A.

Psoriasis Combined with Systemic Amyloidosis: Clinical Observation

Keywords: psoriasis, amyloidosis, Congo Red, thioflavin, melphalan, autologous stem cells

Secondary amyloidosis is a frequent complication of chronic inflammatory processes. That is why comorbid conditions are possible in which the underlying disease is combined with systemic amyloidosis. Once started, secondary amyloidosis becomes an independent process that complicates the course of the underlying disease that caused it and often becomes the main cause of death of the patient. The aim is to present a case report of psoriasis combined with systemic amyloidosis. Material and methods. The material was a clinical case of psoriasis combined with AL-amyloidosis in a 36-year-old patient who was in a state of persistent clinical remission for 12 years after treatment with melphalan in combination with the introduction of autologous stem cells. From the biopsy material of a psoriatic plaque, we made paraffin sections with a thickness of 5 microns, which were stained with hematoxylin and eosin, or hematoxylin and Congo Red, or thioflavin and subjected to light, polarization and luminescence microscopy. Results. Amyloid deposits were found in the dermis of the patient's psoriatic plaque, which were detected by examining sections stained with Congo Red in polarized light and thioflavin under luminescent microscopy. Conclusions. Despite a persistent clinical remission of systemic AL-amyloidosis, comorbid to preceding psoriasis, obtained as a result of the use of a modern pathogenetic method for treating such conditions – a course of melphalan in combination with autologous stem cell support – amyloid deposits in the psoriatic duty plaque were found in the examined patient.

References

Badokin V.V. Vtorichnyi sistemnyi amiloidoz u bol’nykh psoriaticheskim artritom [Secondary systemic amyloidosis in patients with psoriatic arthritis]. Nauchno-prakticheskaya revmatologiya, 2001, no. 4, pp. 84–90.
Pirogova O.V., Kudyasheva O.V., Smirnova A.G., Porunova V.V. et al. Rol’ transplantatsii autologichnykh gemopoeticheskikh stvolovykh kletok v lechenii patsientov s sistemnym AL amiloidozom [The role of autologous hematopoietic stem cell transplantation in the treatment of patients with systemic AL amyloidosis]. Klinicheskaya onkogematologiya, 2023, vol. 16, no. 2, pp. 128–136.
Baldwin A.J., Knowles T.P., Tartaglia G.G. et al. Metastability of native proteins and the phenomenon of amyloid formation. J Am Chem Soc, 2011, vol. 133(36), pp. 14160–14163. DOI: 10.1021/ja2017703.
Benson M.D., Buxbaum J.N., Eisenberg D.S. et al. Amyloid nomenclature 2018: recommendations by the International Society of Amyloidosis (ISA) nomenclature committee. Amyloid, 2018, vol. 25, no. 4, pp. 215–219. DOI: 10.1080/13506129.2018.1549825.
Bu J., Ding R., Zhou L., Chen X., Shen E. Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front Immunol., 2022, no. 13, 880201. DOI: 10.3389/fimmu.2022.880201.
Chiti F., Dobson C.M. Amyloid formation by globular proteins under native conditions. Chem. Biol., 2009, vol. 5, no. 1, pp. 15–22. DOI: 10.1038/nchembio.
Comenzo R.L., Vosburgh E., Simms R.W. et al. Dose-intensive melphalan with blood stem cell support for the treatment of AL amyloidosis: one-year follow-up in five patients. Blood., 1996, vol. 88, no. 7, pp. 2801–2806.
Dear A.J., Michaels T.C.T., Meisl G. et al. Kinetic diversity of amyloid oligomers. Natl. Acad. Sci. USA, 2020, vol. 117, no. 22, pp. 12087–12094. DOI: 10.1073/pnas.1922267117.
Desport E., Bridoux F., Sirac C., Delbes S. et al. Centre national de référence pour l’amylose AL et les autres maladies par dépôts d’immunoglobulines monoclonales. Al amyloidosis [Digital]. Orphanet J. Rare Dis., 2012, no. 7, p. 54. DOI: 10.1186/1750-1172-7-54.
Edlich R.F., Fisher A.L., Chase M.E., Brock C.M. et al. 3^rd. Modern concepts of the diagnosis and treatment of psoriasis. J. Environ. Patho.l Toxicol. Oncol., 2009, vol. 28, no. 3, pp. 235–240. DOI: 10.1615/jenvironpatholtoxicoloncol.v28.i3.50.
Gertz M.A., Lacy M.Q., Dispenzieri A., Buadi F.K. et al. Stem cell transplantation compared with melphalan plus dexamethasone in the treatment of immunoglobulin light-chain amyloidosis. Cancer, 2016, vol. 122, no. 14, pp. 2197–2205. DOI: 10.1002/cncr.30051.
Griffiths C.E., Barker J.N. Pathogenesis and clinical features of psoriasis. Lancet, 2007, vol. 370, no. 9583, pp. 263–271. DOI: 10.1016/S0140-6736(07)61128-3.
Lee J.Y., Hall J.A., Kroehling L., Wu L. et al. Serum Amyloid A Proteins Induce Pathogenic Th17 Cells and Promote Inflammatory Disease. Cell., 2020, vol. 180, no. 1, pp. 79–91.e16. DOI: 10.1016/j.cell.2019.11.026.
Matiiv A.B., Trubitsina N.P., Matveenko A.G. et al. Amyloid and Amyloid-Like Aggregates: Diversity and the Term Crisis. Biochemistry (Mosc), 2020, vol. 85, no. 9, pp. 1011–1034. DOI: 10.1134/S0006297920090035.
Nossent J.C., Gran J.T. Epidemiological and clinical characteristics of psoriatic arthritis in northern Norway. J. Rheumatol., 2009, vol. 38, no. 4, pp. 251–255. DOI: 10.1080/03009740802609558.
Ortiz-Lopez L.I., Choudhary V., Bollag W.B. Updated Perspectives on Keratinocytes and Psoriasis: Keratinocytes are More Than Innocent Bystanders. Psoriasis (Auckl), 2022, no. 12, pp. 73–87. DOI: 10.2147/PTT.S327310.
Perz J.B., Schonland S.O., Hundemer M., Kristen A.V. et al. High-dose melphalan with autologous stem cell transplantation after VAD induction chemotherapy for treatment of amyloid light chain amyloidosis: a single centre prospective phase II study. J. Haematol., 2004, vol. 127, no. 5, pp. 543–551. DOI: 10.1111/j.1365-2141.2004.05232.x.
Povirk L.F., Shuker D.E. DNA damage and mutagenesis induced by nitrogen mustards. Res., 1994, vol. 318, no. 3, pp. 205–226. DOI: 10.1016/0165-1110(94)90015-9.
Sack G.H. Jr. Serum amyloid A – a review. Med., 2018, vol. 24, no. 1, p. 46. DOI: 10.1186/s10020-018-0047-0.
Sanchorawala V. High-Dose Melphalan and Autologous Peripheral Blood Stem Cell Transplantation in AL Amyloidosis. Acta Haematol., 2020, vol. 143, no. 4, pp. 381–387. DOI: 10.1159/000506498.
Schjesvold F.H., Sjo M., Tangen J.M. et al. Høydosebehandling med autolog stamcellestøtte ved systemisk AL-amyloidose [High-dose treatment of systemic AL-amyloidosis with autologous stem cell support]. Nor. Laegeforen. 2008, vol. 128, no. 12, pp. 1392–1396.

About authors

Khusainova Aigul A.: 4th year Student, Medicine Faculty, Chuvash State University, Russia, Cheboksary (husainova.aigiul@yandex.ru; ORCID: https://orcid.org/0009-0006-6561-7679)

Boychev Vyacheslav A.: 4th year Student, Medicine Faculty, Chuvash State University, Russia, Cheboksary (boychev2121@gmail.com; ORCID: https://orcid.org/0009-0001-1204-5017)

Kozlov Vadim A.: Doctor of Biological Sciences, Candidate of Medical Sciences, Professor of the Department of Medical Biology with a course in Microbiology and Virology, Chuvash State University, Russia, Cheboksary (pooh12@yandex.ru; ORCID: https://orcid.org/0000-0001-7488-1240)

Article link

Khusainova A.A., Boychev V.A., Kozlov V.A. Psoriasis Combined with Systemic Amyloidosis: Clinical Observation [Electronic resource] // Acta medica Eurasica. – 2023. – №3. P. 116-125. – URL: https://acta-medica-eurasica.ru/en/single/2023/3/12/. DOI: 10.47026/2413-4864-2023-3-116-125.

Single article

Khusainova A.A., Boychev V.A., Kozlov V.A.