Secondary (AA) amyloid is seen in all except ?
**Core Concept**
Secondary (AA) amyloidosis is a condition where amyloid A (AA) proteins accumulate in the body due to chronic inflammation or infection. It is characterized by the deposition of AA fibrils in various organs, leading to organ dysfunction.
**Why the Correct Answer is Right**
The correct answer is related to the underlying pathophysiology of secondary amyloidosis. AA proteins are produced in response to chronic inflammation, which is typically caused by infections such as tuberculosis, osteomyelitis, or chronic inflammatory diseases like rheumatoid arthritis. The AA proteins are produced by macrophages and other cells in response to the inflammatory stimulus, and they can then accumulate and deposit in organs such as the kidneys, liver, and heart.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because secondary amyloidosis is indeed seen in chronic infections such as tuberculosis, which is a classic cause of AA amyloidosis.
**Option B:** This option is incorrect because secondary amyloidosis is a known complication of chronic inflammatory diseases such as rheumatoid arthritis, which is characterized by chronic inflammation and joint damage.
**Option C:** This option is incorrect because secondary amyloidosis is also seen in chronic infections such as osteomyelitis, which is an infection of the bone tissue.
**Option D:** This option is incorrect because primary (AL) amyloidosis is a different condition characterized by the deposition of light chain proteins produced by plasma cells, whereas secondary (AA) amyloidosis is caused by the deposition of AA proteins in response to chronic inflammation.
**Clinical Pearl / High-Yield Fact**
To remember the difference between secondary and primary amyloidosis, recall that secondary amyloidosis is caused by chronic inflammation, while primary amyloidosis is caused by plasma cell dyscrasias.
**Correct Answer:** D. Primary (AL) amyloidosis.