الفهرس 
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Abstract
The aim of the study was therefore to screen for amyloid in fat tissue of Egyptian patients with rheumatoid arthritis by two different methods in order to assess the prevalence of amyloid, possible risk factors for its development, and associated clinical characteristics.
To conclude, amyloid is present in Egyptian patients with RA. The prevalence of amyloid is 7% and increases to 26% in a selected group of patients with a combination of long disease duration and a moderate to low number of RBC. This selected group represents those patients particularly at risk of having amyloid. Co morbidity in the form of concurrent bronchopulmonary disease may be an additional risk factor to look for.
The abdominal subcutaneous fast aspiration is a suitable tool to identify patients with preclinical amyloidosis. Quantification of amyloid A protein concentration is highly specific method for amyloid detection in fat tissue and the combination of this method with the Congo red method makes it more objective and convenient to detect small amounts of amyloid.
The amount of amyloid of this study group is low. Proteinuria and impaired renal function are not sensitive markers to detect amyloidosis in RA patients.
It seems that constipation, a small number of swollen joints, a low acute phase response, and a small number of red blood cells are prominent features of these Egyptian patients. However, many RA patients in this study with amyloidosis are completely asymptomatic.
Follow up studies are needed to investigate whether this ”silent” amyloidosis will eventually develop into clinically significant amyloidosis, since it seems prudent to take a conservative approach, and not to treat aggressively with cytotoxic drugs at this stage. A longer follow up is required to evaluate the duration of the preclinical status.