Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration

Anita D'Souza, Jason D. Theis, Julie A. Vrana, Ahmet Dogan

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Protein and peptide drugs administered subcutaneously, such as insulin can be amyloidogenic and result in localized amyloid deposits at the sites of medication injections. These iatrogenic amyloidoses typically present as a localized subcutaneous nodule or skin reaction at the site of administration, and often pose diagnostic challenges. We have analyzed the amyloid proteome in 52 cases of insulin and enfuvirtide associated amyloidosis using laser microdissection/tandem mass spectrometry. We show that the deposits are composed of the drug, as well as other amyloid precursor proteins such as apolipoproteins A-I, A-IV, E and serum amyloid protein. Mass spectrometry-based amyloid sub-typing allows for accurate amyloid diagnosis with resultant therapeutic and prognostic implications. This insight into the amyloid proteome in drug-induced amyloidosis may help further understand pathogenesis of amyloid fibril formation.

Original languageEnglish (US)
Pages (from-to)71-75
Number of pages5
Issue number2
StatePublished - Jun 2014


  • Drug-induced amyloid
  • Iatrogenic
  • Pharmaceutical amyloidosis

ASJC Scopus subject areas

  • Internal Medicine


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