A review of the literature on
Crohn's disease with secondary
amyloidosis and four own case reports are presented. At least 1% of patients with
Crohn's disease develop
amyloidosis. The extent of the
inflammatory bowel disease seems to have an influence on the occurrence of
amyloidosis. The survival time of 40 out of 72 patients was 2.1 years after the onset of diagnosis. The complications induced by the
amyloidosis determine the fate of the patients. Therefore the periodical
protein determination in urine and the
Congo-red-colouring of rectal mucosa after rectoscopy are justified. After the diagnosis of
amyloidosis in patients with
Crohn's disease the
inflammation should be treated consequently, according to the principles of the treatment of the underlying disease. But the resection of the inflammatory bowel should be avoided if the renal function is still sufficient, because frequently there occurs a postoperative
renal failure. In the case of renal
amyloidosis with a creatinin-clearance of more than 10 ml/min, a therapeutic attempt should be made with 1.0 to 1.5 mg/day of colchicin or 10 g/day dimethylsulphoxid (
DMSO) for at least six months. During existing
renal failure the proceeding of
amyloidosis in other organs is to be expected. The secondary
amyloidosis disposes the fate of the patients.