Amyloidosis (AL and AA)
What is Amyloidosis (AL and AA)?
Amyloidosis is a rare condition where abnormal proteins called amyloid build up in your organs and tissues. These proteins fold incorrectly and stick together, forming deposits that can damage your kidneys, heart, liver, and nervous system. Over time, these deposits interfere with normal organ function.
There are two main types. AL amyloidosis, also called primary amyloidosis, happens when your bone marrow produces abnormal antibodies. AA amyloidosis, also called secondary amyloidosis, develops in response to chronic inflammation or infection. Both types can affect the kidneys, which often shows up first as protein in your urine.
Amyloidosis is serious but manageable with early detection. Treatment focuses on stopping the production of amyloid proteins and managing symptoms. Regular monitoring helps catch organ damage before it becomes severe.
Symptoms
- Severe fatigue and weakness that interferes with daily activities
- Swelling in your ankles, legs, or feet from fluid buildup
- Shortness of breath, especially when lying down or during activity
- Numbness or tingling in your hands and feet
- Unintentional weight loss of 10 pounds or more
- Easy bruising or purple patches around your eyes
- Enlarged tongue or difficulty swallowing
- Irregular heartbeat or feeling dizzy when standing
- Foamy urine from excess protein
- Diarrhea or constipation that persists
Many people have no symptoms in the early stages. Kidney involvement often appears before other symptoms become noticeable. This makes regular screening important for people at risk.
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Causes and risk factors
AL amyloidosis happens when plasma cells in your bone marrow produce abnormal antibody proteins. These misfolded proteins cannot be broken down normally and build up in organs. Doctors do not fully understand why this happens, but it is more common in people over 60. It affects men more often than women and is not passed down genetically in most cases.
AA amyloidosis develops as a complication of chronic inflammatory diseases. Conditions like rheumatoid arthritis, inflammatory bowel disease, chronic infections, and tuberculosis can trigger it. Your body makes too much of a protein called serum amyloid A during long periods of inflammation. Over months or years, this protein deposits in organs. Managing the underlying inflammatory condition is key to prevention.
How it's diagnosed
Doctors diagnose amyloidosis through a combination of tests. A tissue biopsy is the gold standard, where a small sample from your kidney, fat, or bone marrow is examined under a microscope for amyloid deposits. Blood tests check for abnormal antibodies in AL amyloidosis. Imaging like echocardiograms or MRI scans assess organ damage.
Urine protein testing is often the first indicator of kidney involvement in amyloidosis. When amyloid proteins damage the kidneys, large amounts of protein leak into your urine. Rite Aid offers urine protein screening as part of our testing panel. Early detection through regular testing helps you catch kidney problems before they progress. This gives you time to work with specialists on treatment options.
Treatment options
- Chemotherapy or targeted drugs to stop abnormal protein production in AL amyloidosis
- Anti-inflammatory medications to control underlying conditions in AA amyloidosis
- Diuretics, or water pills, to reduce swelling and fluid buildup
- Heart medications to manage irregular heartbeat and blood pressure
- Low-salt diet to help control swelling and protect kidney function
- Moderate protein intake as directed by your doctor to reduce kidney stress
- Stem cell transplant in select cases of AL amyloidosis to reset bone marrow
- Regular monitoring with blood and urine tests every 3 to 6 months
- Physical therapy to maintain strength and manage nerve symptoms
- Treatment of infections or inflammatory diseases promptly in AA amyloidosis
Concerned about Amyloidosis (AL and AA)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
AL amyloidosis, or primary amyloidosis, is caused by abnormal antibody proteins produced by bone marrow plasma cells. AA amyloidosis, or secondary amyloidosis, develops from chronic inflammation due to conditions like rheumatoid arthritis or infections. Both types cause protein deposits in organs, but they require different treatments. AL amyloidosis needs chemotherapy or targeted drugs, while AA amyloidosis requires control of the underlying inflammatory disease.
There is no cure for amyloidosis, but treatment can slow or stop the progression. In AL amyloidosis, chemotherapy and stem cell transplants can stop production of abnormal proteins. In AA amyloidosis, treating the underlying inflammatory condition can stop new amyloid deposits. Early treatment improves outcomes and can prevent organ failure. Many people live for years with proper management.
Amyloid proteins deposit in the tiny filtering units of your kidneys called glomeruli. This damage causes large amounts of protein to leak into your urine, a condition called nephrotic syndrome. You may notice foamy urine or swelling in your legs. Over time, untreated kidney amyloidosis can lead to kidney failure requiring dialysis.
Protein in your urine is often the first sign that amyloidosis is affecting your kidneys. Normal kidneys filter waste but keep protein in your blood. When amyloid damages kidney filters, protein leaks through. Regular urine protein testing helps track kidney function and treatment response.
If you have chronic inflammatory diseases like rheumatoid arthritis or inflammatory bowel disease, ask your doctor about screening every 6 to 12 months. People over 60 with unexplained symptoms like fatigue or swelling should discuss testing. Urine protein screening can catch kidney involvement early. Regular monitoring allows for earlier intervention.
AL and AA amyloidosis are not typically hereditary. However, there is a rare hereditary form called familial amyloidosis caused by genetic mutations. This type runs in families and usually affects the nerves and heart. If you have a family history of amyloidosis, genetic counseling can help assess your risk.
A low-salt diet helps reduce fluid retention and swelling. Limit sodium to under 2,000 milligrams per day. Stay moderately active to maintain muscle strength, but rest when fatigued. Avoid NSAIDs like ibuprofen as they can harm kidneys. Work closely with a dietitian and your medical team to create a personalized plan.
Yes, AL amyloidosis can relapse if abnormal plasma cells start producing amyloid proteins again. Regular blood and urine tests every 3 to 6 months help detect relapse early. In AA amyloidosis, new deposits can form if the underlying inflammatory disease flares up. Consistent disease management and monitoring reduce relapse risk.
Survival depends on the type, organs affected, and how early treatment begins. With modern therapies, many people with AL amyloidosis live 5 years or longer. AA amyloidosis prognosis improves when the underlying inflammatory condition is controlled. Early detection and treatment significantly improve outcomes. Your doctor can provide personalized information based on your specific case.
Yes, amyloidosis requires care from specialists. A hematologist treats AL amyloidosis with chemotherapy and stem cell transplants. A rheumatologist or infectious disease doctor manages underlying conditions in AA amyloidosis. A nephrologist monitors kidney function. Work with your primary care doctor to coordinate referrals and build a comprehensive care team.