Rheumatoid arthritis cardiac involvement

In AL amyloidosis, amyloid is formed from degradation products of the X or k light chains that deposit most frequently in the extracellular matrix of the kidney and the heart but also may deposit in the tongue. In other types of amyloidosis, the amyloid arises from other proteins and deposits in a characteristic organ. For example, the amyloid associated with chronic inflammatory conditions, such as tuberculosis or rheumatoid arthritis, is derived from an acute phase serum protein called serum amyloid Athat is produced by the liver in response to inflammation. It deposits most frequently in the kidney, and cardiac involvement is rare. 

Infection risk The risk of infections and serious infections with rituximab may be similar to that with the TNT antagonists. To date, there have been no reports from trials of an increased risk of tuberculosis or opportunistic infections with rituximab [162 ]. Some investigators have reported an increase in Pneumocystis jirovecii pneumonia, and increased number of infections has been documented in patients treated with maintenance rituximab for low-grade lymphoma and in patients with concomitant severe immunodeficiency, whether caused by HIV or immunosuppressive agents [152 ]. In rheumatoid arthritis, the susceptibility factors for severe infections include chronic lung and/or cardiac disease, extra-articular involvement, and low IgG before rituximab treatment [163 ]. After kidney transplantation, the off-label use of rituximab is associated with a high risk of infectious disease and death related to infectious disease [164 ]. 

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