Anakinra-Associated Amyloidosis

Amyloidoses are caused by the extracellular deposition of insoluble misfolded proteins. Of the 36 different amyloidogenic proteins,1 most are produced endogenously, but some are exogenous from subcutaneous injection of protein medications, such as insulin and liraglutide.2,3 As treatment regimens vary depending on the patient’s amyloidogenic protein levels, accurate amyloid typing is critical for treating patients. In this article, we present 2 cases of iatrogenic amyloidosis secondary to subcutaneous injections of anakinra to manage neonatal-onset multisystem inflammatory disease (NOMID).