ABSTRACT Amyloid A (AA) amyloidosis is a serious complication of chronic inflammatory diseases, including rheumatoid arthritis (RA). A 78‐year‐old woman with advanced dementia developed progressive renal dysfunction following prolonged, unintentional RA treatment discontinuation. Laboratory evaluation demonstrated elevated inflammatory markers, serum AA levels, and proteinuria. Because renal biopsy was not feasible, an abdominal skin punch biopsy revealed AA amyloid deposition despite the absence of skin lesions. Low‐dose glucocorticoids improved inflammatory markers; however, renal dysfunction persisted. This case highlights the risk of treatment interruption in cognitively impaired older adults and the diagnostic value of skin biopsy.
Ishiguro et al. (2026) studied this question.