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Intestinal Amyloidosis - Treatment
Last reviewed: 04.07.2025
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In amyloidosis, including intestinal amyloidosis, a complex of medications is recommended that affect the main links in the pathogenesis of the disease.
In order to influence the intracellular synthesis of amyloid protein, derivatives of 4-aminoquinoline (chloroquine, delagyl, plaquenil), corticosteroid hormones in small and medium doses, colchicine, immunostimulants: T- and B-activin, levamisole are prescribed. Thiol compounds (glutathione, unithiol) inhibit the formation of amyloid, which has been confirmed by experimental studies. Antihistamines prevent the connection of fibrillar amyloid protein with other tissue and plasma components. Finally, since the fact of amyloid resorption has been established, agents stimulating amyloid resorption are effective: ascorbic acid, anabolic hormones, liver preparations. In secondary amyloidosis, the underlying disease should be treated first.
In recent years, there have been reports of successful treatment of amyloidosis in periodic disease and rheumatoid arthritis with colchicine. The effectiveness of therapy with this drug has been confirmed by studying repeated biopsies of the rectal mucosa.
A case of recovery from intestinal and gastric amyloidosis (type AA), complicating chronic ulcerative colitis, is described with treatment with salazopyrine (3 g/day) and prednisolone (30 mg/day) in combination with blood transfusions.
Data were obtained on the successful use (improvement of endoscopic and histological parameters) of dimethyl sulfoxide and prednisolone in gastrointestinal amyloidosis (type AA) in a 37-year-old man with Still's disease.
However, domestic researchers are cautious about the use of dimethyl sulfoxide in amyloidosis, preferring colchicine and its analogues.
Primary amyloidosis is virtually untreatable. Cytostatics in combination with prednisolone only lead to subjective improvement.
Treatment of any form of intestinal amyloidosis involves the inclusion in the complex of therapeutic measures of agents that affect diarrhea and replenish the deficiency of a number of substances that arise as a result of impaired absorption.
Prevention of secondary amyloidosis is the prevention of chronic purulent-inflammatory, autoimmune and tumor diseases from the group of paraproteinemic leukemia.
The prognosis for intestinal amyloidosis is unfavorable, especially when malabsorption syndrome occurs, as well as such serious complications as bleeding and intestinal perforation. Involvement of the kidneys in the pathological process aggravates the prognosis. At the same time, the possibility of amyloid resorption in secondary amyloidosis against the background of colchicine treatment makes the prognosis for this form of the disease more favorable.
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