AA amyloidosis complicating sarcoidosis: two cases and literature review

Sarcoidosis is a relatively common granulomatosis. Its outcome is usually favourable. AA amyloidosis is a rare complication of sarcoidosis. We report two new cases and review the literature. A 40-year-old woman followed for a splenomegaly was admitted for assessment of hepatic cholestasis. The diagnosis of sarcoidosis involving lungs, liver, spleen and lymph nodes was obtained on clinical, biological and histological evidence. Simultaneously, AA amyloidosis deposits was demonstrated on lymph nodes and spleen. The second patient was a 42-year-old woman who was evaluated for mediastinal lymph nodes and interstitial pneumonia. Lung biopsy showed epithelioid and giant cell granuloma without caseous necrosis, associated to AA amyloidosis deposits. In these two patients, corticosteroids (initially at 1 mg/kg daily) led to a sustained improvement with a 1 and 5 years follow-up, respectively. AA amyloidosis is an uncommon complication of sarcoidosis. Corticosteroids associated with colchicine is proposed to treat simultaneously the two disorders.