Amyloidosis: diagnosis and prognosis

  title={Amyloidosis: diagnosis and prognosis},
  author={Morie A. Gertz},
  journal={Future Rheumatology},
  • M. Gertz
  • Published 2008
  • Medicine
  • Future Rheumatology
All patients with amyloidosis must have Congo red-stained deposits demonstrating green birefringence under polarized light. Subcutaneous fat is the easiest source for such tissue. Amyloid deposits must be characterized to establish systemic or localized disease, and all forms of systemic amyloidosis must be classified using immunohistochemistry, immunofluorescence, genetic testing for mutations known to be associated with familial amyloidosis or mass spectroscopy techniques. Where available… Expand
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Clinical history, IF, and IHC are essential in amyloid typing because they provide a subtle guide regarding the severity of disease in the background of a wide range of morphological features and biochemical values. Expand
Novel treatments for systemic amyloidosis
Since cardiac involvement is vital when deciding on therapy, the introduction of N-terminal probrain natriuretic peptide (NT-proBNP) and troponin are of great importance and determination of serum free light chains has become indispensable in the diagnosis and follow-up of AL amyloidosis. Expand
A 16-year Survey of Clinicopathological Findings, Electron Microscopy, and Classification of Renal Amyloidosis
The severity of glomerular amyloid depositions had a clear relationship with clinical presentations and EM in conjunction with LM investigation with Congo red staining is recommended to prevent misdiagnosis of patients with a clinical suspicion of renal amyloidsosis. Expand
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Subcutaneous fat tissue for diagnosis and studies of systemic amyloidosis.
Subcutaneous fat biopsy is a simple and safe method to obtain a diagnosis of systemic amyloidosis and the material can be used for exact determination of amyloids type. Expand
Characterization of systemic amyloid deposits by mass spectrometry.
Micro-methods are developed, whereby this information can be obtained by tandem mass spectrometry (MS/MS) using material extracted from formalin-fixed, amyloid-containing tissue biopsy specimens or subcutaneous fat aspirates, which have diagnostic, therapeutic, and prognostic implications for patients with amyloids-associated disease. Expand
AL-amyloidosis is underdiagnosed in renal biopsies.
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  • Medicine
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  • 2004
The data demonstrated the low sensitivity of immunofluorescence microscopy in the detection of AL-amyloidosis in the kidney and underscore the need to pursue additional diagnostic studies to identify this problem. Expand
Premortem recognition of systemic senile amyloidosis with cardiac involvement
Patients with cardiac amyloid and no monoclonal protein in the serum or urine must have immunohistochemical staining for kappa and lambda light chains and transthyretin to distinguish between systemic senile amyloidsosis, familial amyloidalosis, and AL. Expand
Tc-99m HDP uptake in cardiac amyloidosis.
Isolated cardiac uptake of Tc-99m HDP is described in a patient with biopsy-proved cardiac amyloidosis on a background of tuberculosis, prostate cancer, and coronary artery disease. Expand
Diagnostic and therapeutic approach of systemic amyloidosis.
In this evaluation serum amyloid P component (SAP) scintigraphy helps to show organ involvement and therapy response and the choice of therapy is based on the 'precursor-product' concept. Expand
New insights into systemic amyloidosis: the importance of diagnosis of specific type
  • M. Picken
  • Medicine
  • Current opinion in nephrology and hypertension
  • 2007
The role of immunohistochemistry – the current standard of care in amyloid typing – is evolving with emergence of alternative biochemical methods, and presents an attractive venue for the application of proteomics methodologies, despite their inherent complexities. Expand
Misdiagnosis of hereditary amyloidosis as AL (primary) amyloidosis.
A genetic cause should be sought in all patients with amyloidsosis that is not the reactive systemic amyloid A type and in whom confirmation of the light-chain (AL) type cannot be obtained. Expand
Utility of subcutaneous fat aspiration for the diagnosis of systemic amyloidosis (immunoglobulin light chain).
Subcutaneous fat aspiration was as sensitive as rectal biopsy and substantially more sensitive than bone marrow biopsy in diagnosing amyloidosis and in six instances fat aspiration would have obviated the need for a more invasive diagnostic biopsy. Expand
Immunochemical microanalysis of amyloid proteins in fine-needle aspirates of abdominal fat.
The fine-needle aspiration biopsy method provides rapid and reliable diagnostic information necessary for classification of the chemical type of amyloid required for initiation of specific modes of therapy, with little discomfort to the patient. Expand