Breathnach, S. "Amyloid and amyloidosis". J Am Acad Dermatol. vol. 18. 1988. pp. 1-16. (This 1988 review still offers an excellent overview of primary systemic amyloidosis. Although the prognosis and treatment information is outdated, the sections covering the pathogenesis, histopathology clinical/diagnostic features (including cutaneous findings with images) comprehensively summarizes the current information found in the literature for primary systemic amyloidosis. This manuscript also provides a decent overview of primary localized cutaneous amyloidosis but most of the text is dedicated to primary systemic amyloidosis.). Borowicz, J, Gillespie, M, Miller, R. "Cutaneous amyloidosis". Skinmed. vol. 2. 2011. pp. 96-100. (Within this brief overview of cutaneous amyloidosis, this manuscript provides a current summary of the treatment options for nodular cutaneous amyloidosis with a focus on literature findings for dermabrasion, carbon dioxide laser therapy, and pulse dye laser treatment.). Desai, ...
Acceptance of any contribution, gift or grant is at the discretion of the NZ ATTR Amyloidosis Patients Association (NZAPA). The NZ ATTR Amyloidosis Patients Association (NZAPA) will not accept any gift unless it can be used or expended consistently with the purpose and mission of the NZ ATTR Amyloidosis Patients Association (NZAPA).. No irrevocable gift, whether outright or life-income in character, will be accepted if under any reasonable set of circumstances the gift would jeopardize the donors financial security.. The NZ ATTR Amyloidosis Patients Association (NZAPA) will refrain from providing advice about the tax or other treatment of gifts and will encourage donors to seek guidance from their own professional advisers to assist them in the process of making their donation.. The NZ ATTR Amyloidosis Patients Association (NZAPA) will accept donations of cash or publicly traded securities. Gifts of in-kind services will be accepted at the discretion of the NZ ATTR Amyloidosis Patients ...
TY - JOUR. T1 - Isolated nodular pulmonary amyloidosis. T2 - Diagnosis by percutaneous needle aspiration biopsy. AU - Scott, Penelope P.. AU - Scott, William W.. PY - 1985/4. Y1 - 1985/4. N2 - We have reported three cases of isolated nodular pulmonary amyloidosis, a rare condition whose roentgenographic presentation frequently mimics tumor metastatic to the lung or primary lung cancer. Computerized tomography is not helpful in diagnosing this condition. In our experience, the specific diagnosis could be made by aspiration needle biopsy, avoiding thoracotomy.. AB - We have reported three cases of isolated nodular pulmonary amyloidosis, a rare condition whose roentgenographic presentation frequently mimics tumor metastatic to the lung or primary lung cancer. Computerized tomography is not helpful in diagnosing this condition. In our experience, the specific diagnosis could be made by aspiration needle biopsy, avoiding thoracotomy.. UR - ...
AL Amyloidosis is known to be a systemic disease affecting multiple organs and tissue while its rare that patients present with gastrointestinal symptoms at first and later develop multiple-organ dysfuction. Clinical signs are not specific and the diagnosis is rarely given before performing immunofixation and endoscopy with multiple biopsies. We would like to emphasize the value of precise diagnostic process of AL amyloidosis. In this case report, we describe a 56-year-old man who presented with recurrent periumbilical pain for 4 months and gradually worsened over a month. After a series of tests, he was finally diagnosed with primary systemic AL amyloidosis. He was treated with a chemotherapy regimen (Melphalan, dexamethasone and thalidomide) achieving a good clinical response. On account of the high misdiagnosis rate, establishing the most precise diagnosis in first time with typing amyloidogenic protein becomes increasingly vital. Although the presenting feature is usually nonspecific, AL
TY - JOUR. T1 - Immunoglobulin light chain amyloidosis is diagnosed late in patients with preexisting plasma cell dyscrasias. AU - Kourelis, Taxiarchis. AU - Kumar, Shaji K. AU - Go, Ronald S.. AU - Kapoor, Prashant. AU - Kyle, Robert A.. AU - Buadi, Francis K.. AU - Gertz, Morie. AU - Lacy, Martha. AU - Hayman, Suzanne R.. AU - Leung, Nelson. AU - Dingli, David M. AU - Lust, John A.. AU - Lin, Yi. AU - Zeldenrust, Stephen R.. AU - Rajkumar, S Vincent. AU - Dispenzieri, Angela. PY - 2014/11/1. Y1 - 2014/11/1. N2 - AL amyloidosis (AL) is rare and frequently remains undiagnosed until organ function is compromised, even among patients with known pre-existing untreated plasma cell dyscrasias (PCD). We identified 168 patients with AL amyloidosis who had a prior untreated PCD. The earliest symptom or sign (s/s) was defined as the first symptom reported by the patient that could be attributed to organ dysfunction caused by AL. The interval from the time of development of s/s to the establishment of ...
Immunoglobulin light chain amyloidosis (AL) is a plasma cell dyscrasia characterized by deposition of amyloid fibrils in various organs and tissues, derived from monoclonal light chains, leading to organ dysfunction.1-3 High-dose melphalan with autologous stem cell transplant (HDM/SCT) is an effective treatment with high complete hematologic response rates (CR) and is capable of producing durable remissions and prolonged overall survival.4-6 Only selected patients are eligible to receive HDM/SCT, and treatment-related mortality is in the range of 5-15%. More effective and widely applicable treatment modalities in AL amyloidosis are, therefore, needed.. Clinical trials of alternate treatment options have tested non-transplant melphalan-based strategies and novel therapeutics such as lenalidomide and bortezomib. Oral melphalan and dexamethasone (M-Dex) is a standard regimen for patients not eligible to receive HDM/SCT; reported complete response rates range from 13% to 33% and median overall ...
This case report concerns a patient who presented a diagnostic problem of cardiomegaly and myocardial failure of unknown etiology and in whom the outstanding pathologic finding at autopsy was primary systemic amyloidosis with marked cardiac involvement. An additional finding of great interest was the presence of numerous Russell bodies in the bone marrow. For previously reported cases (approximately 100) and reviews of the literature of primary systemic amyloidosis,1-14 we found no report of similar bone marrow findings though Snapper, Turner and Moscovitz15 have reported Russell bodies in the bone marrow in atypical amyloidosis accompanying multiple myeloma. Morphologically, amyloidosis associated with ...
AA amyloidosis is a form of amyloidosis, a disease characterized by the abnormal deposition of fibers of insoluble protein in the extracellular space of various tissues and organs. In AA amyloidosis, the deposited protein is serum amyloid A protein (SAA), an acute-phase protein which is normally soluble and whose plasma concentration is highest during inflammation. AA amyloidosis is a complication of a number of inflammatory diseases and infections, although only a small portion of patients with these conditions will go on to develop AA amyloidosis. A natural history study of AA amyloidosis patients published in the New England Journal of Medicine reported a number of conditions associated with AA amyloidosis. The most common presentation of AA amyloidosis is renal in nature, including proteinuria, nephrotic syndrome and progressive development of renal insufficiency leading to End Stage Renal Disease (ESRD) and need for renal replacement therapy (e.g. dialysis or renal transplantation). ...
Systemic amyloidosis can be classified as follows: (1) primary systemic amyloidosis (PSA), usually with no evidence of preceding or coexisting disease, paraproteinemia, or plasma-cell dyscrasia; (2) amyloidosis associated with multiple myeloma; or (3) secondary systemic amyloidosis with evidence of coexisting previous chronic inflammatory or ...
Amyloidosis is a disorder caused by misfolding of autologous protein and its extracellular deposition as fibrils, resulting in vital organ dysfunction and eventually death. Pulmonary amyloidosis may be localised or part of systemic amyloidosis.. Pulmonary interstitial amyloidosis is symptomatic only if the amyloid deposits severely affect gas exchange alveolar structure, thus resulting in serious respiratory impairment. Localised parenchymal involvement may be present as nodular amyloidosis or as amyloid deposits associated with localised lymphomas. Finally, tracheobronchial amyloidosis, which is usually not associated with evident clonal proliferation, may result in airway stenosis.. Because the treatment options for amyloidosis are dependent on the fibril protein type, the workup of all new cases should include accurate determination of the amyloid protein. Most cases are asymptomatic and need only a careful follow-up. Diffuse alveolar-septal amyloidosis is treated according to the underlying ...
... is a disease in which amyloid, an unusual protein that normally isnt present in the body, accumulates in various tissues.. Many forms of amyloidosis exist. In primary amyloidosis, the cause isnt known. However, the disease is associated with abnormalities of plasma cells, as is multiple myeloma, which may also be associated with amyloidosis. In secondary amyloidosis, the amyloidosis is secondary to another disease such as tuberculosis, infections of the bone, rheumatoid arthritis, familial Mediterranean fever, or granulomatous ileitis. A third form, hereditary amyloidosis, affects nerves and certain organs; it has been noted in people from Portugal, Sweden, Japan, and many other countries.. Another form of amyloidosis is associated with normal aging and particularly affects the heart. What causes amyloid to build up excessively usually isnt known. However, amyloidosis can be a response to various diseases that cause persistent infection or inflammation. Yet another form of ...
Amyloidosis is the extracellular deposition of insoluble amyloid fibrilprotein in any tissue or organ.[1] The most common subtypes of the disease are AL amyloidosis and AA reactive amyloidosis.[1] AL amyloidosis is a systemic disease caused by immunoglobulin light chain fragments, while AA amyloidosis is a potential complication of recurrent inflammation leading to the production of serum amyloid A, an acute phase reactant.[2] Pulmonary amyloidosis is a localized form of amyloid deposition that is confined to the lung parenchyma.[
TY - JOUR. T1 - Blood stem cell transplantation as therapy for primary systemic amyloidosis (AL). AU - Gertz, Morie. AU - Lacy, Martha. AU - Gastineau, D. A.. AU - Inwards, D. J.. AU - Chen, M. G.. AU - Tefferi, Ayalew. AU - Kyle, R. A.. AU - Litzow, Mark R. PY - 2000. Y1 - 2000. N2 - This study investigated the response rate and toxicity of blood cell transplantation as treatment for primary amyloidosis (AL). Twenty-three patients had stem cells collected between November 1995 and September 1998. Conditioning included melphalan and total body irradiation in 16 and melphalan alone in 4. Three patients did not undergo stem cell infusion because of poor performance status. Two died of progressive amyloid at 1 and 3 months. One patient is alive on hemodialysis. Fourteen males and six females (median age, 57 years) underwent transplantation. Renal, cardiac (by echocardiography), peripheral neuropathy or liver amyloidosis occurred in 14, 12, 3, and 1, respectively. Echocardiography demonstrated an ...
Demographics: Patients can be of almost any age, from childhood to elderly, depending on the underlying cause. Primary amyloidosis shows a male predominance.. Cardinal Findings: In primary amyloidosis, the most commonly involved organs are the kidney, heart, liver, and skin; skeletal muscle and the tongue may also be affected. Peripheral neuropathies are seen, but the central nervous system (CNS) is generally not involved. Secondary amyloidosis most commonly presents with nephrotic syndrome or gastrointestinal (GI) bleeding. Macroglossia is not seen with secondary amyloidosis. The initial finding in hemodialysis associated amyloid is often CTS.. Uncommon Manifestations: In primary amyloidosis, amyloid deposits may be seen in the synovium and occasionally in the synovial fluid.. Diagnostic Tests: Biopsies of affected tissues are usually required. The tissues are stained with Congo red and viewed under polarized light. Kidney and peripheral nerve biopsy specimens can be useful if there are known ...
Nodular pulmonary amyloidosis (NPA) is an uncommon pathology of insoluble protein depositing in pulmonary parenchyma. This localized pulmonary form of amyloidosis is most often found to contain combinations of kappa and lambda immunoglobulin light chain and immunoglobulin heavy chain proteins with a polyclonal lymphoplasmacystic infiltrate. Herein we present two cases of NPA of the rarely reported monoclonal (light-chain restricted) form with review of the literature and discussion of the clinical, radiographic, and histologic features of NPA.
The UK ATTR Amyloidosis Patients Association (UKATPA) was founded in 2017 by a group of UK patients with transthyretin (TTR)-type systemic amyloidosis (ATTR), supported by the consultant physicians of the UK NHS National Amyloidosis Centre.. In recent years there have been major advances in the field of ATTR amyloidosis. The processes responsible for formation of TTR amyloid have been elucidated for the first time and intense activity in drug development promises the early advent of potentially effective prophylactic and disease modifying new medicines. Hereditary ATTR amyloidosis, caused by mutations in the TTR gene, is the most common form of hereditary amyloidosis but is nonetheless very rare. However, crucially, there is now compelling evidence that acquired ATTR amyloidosis, caused by normal wild type TTR, is far more common than was previously believed.. In this exciting environment of change and optimism, our members decided to found a UK patient group dedicated to the interests of ...
TY - CHAP. T1 - Definition of organ involvement and treatment response in primary systemic amyloidosis (Al). T2 - A consensus opinion from the 10 th international symposium on amyloid and amyloidosis. AU - Gertz, Morie A.. AU - Comenzo, Ray. AU - Falk, Rodney H.. AU - Fermand, Jean Paul. AU - Hazenberg, Bouke P.. AU - Hawkins, Philip N.. AU - Merlini, Giampaolo. AU - Moreau, Philippe. AU - Ronco, Pierre. AU - Sanchorawala, Vaishali. AU - Sezer, Orhan. AU - Solomon, Alan. AU - Grateau, Giles. PY - 2004/1/1. Y1 - 2004/1/1. UR - http://www.scopus.com/inward/record.url?scp=17744382676&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=17744382676&partnerID=8YFLogxK. M3 - Chapter. SN - 0849335345. SN - 9780849335341. SP - 151. EP - 153. BT - Amyloid and Amyloidosis. PB - CRC Press. ER - ...
TY - JOUR. T1 - Hereditary systemic immunoglobulin light-chain amyloidosis. AU - Benson, Merrill. AU - Liepnieks, Juris J.. AU - Kluve-Beckerman, Barbara. PY - 2015. Y1 - 2015. N2 - Several members of a family died from renal failure as a result of systemic amyloidosis. Extensive studies to detect previously documented gene mutations associated with amyloidosis failed to identify a causative factor. In search of the genetic basis for this syndrome, amyloid fibrils were isolated from renal tissue of a member of the kin who died while on renal dialysis. Amino acid sequencing of isolated amyloid protein identified sequences compatible with the constant region of the immunoglobulin κ light-chain. Isolation and characterization of κ light-chain protein from serum of an affected member of the kindred revealed mutation in the constant region of kκlight-chain, with cysteine replacing serine at amino acid residue 131. This mutation (Ser131Cys) was confirmed by DNA analysis, which identified a ...
Abstract. Background: Primary systemic amyloidosis (AL) is an incurable plasma cell disorder. Lenalidomide, especially in conjunction with dexamethasone, has b
1. Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med 2003; 349(6): 583-596. 2. Loss M, Ng WS, Karim RZ et al. Hereditary lysozyme amyloidosis: spontaneous hepatic rupture (15 years apart) in mother and daughter. role of emergency liver transplantation. Liver Transpl 2006; 12(7): 1152-1155. 3. Michowska M, Boj E, Wrzołkowa T et al. A First Case of Liver Rupture In Transthyretin (TTR) Familial Amyloid Polyneuropathy. Exp Clin Hep 2005; 1(2): 109-112. 4. Gertz MA, Kyle RA. Hepatic amyloidosis: clinical appraisal in 77 patients. Hepatology 1997; 25(1): 118-121. 5. Comenzo RL, Zhang Y, Martinez C et al. The tropism of organ involvement in primary systemic amyloidosis: contributions of Ig V(L) germ line gene use and clonal plasma cell burden. Blood 2001; 98(3): 714-720. 6. Solomon A, Macy SD, Wooliver C et al. Splenic plasma cells can serve as a source of amyloidogenic light chains. Blood 2009; 113(7): 1501-1503. 7. Park MA, Mueller PS, Kyle RA et al. Primary (AL) hepatic ...
RATIONALE: Giving melphalan and bortezomib before and after a stem cell transplant stops the growth of abnormal cells by stopping them from dividing or killing them. Giving colony-stimulating factors and certain chemotherapy drugs, helps stem cells move from the bone marrow to the blood so they can be collected and stored. Chemotherapy and monoclonal antibody therapy is then given to prepare the bone marrow for the stem cell transplant. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy.. PURPOSE: This phase II trial is studying how well giving melphalan together with bortezomib followed by stem cell transplant works in treating patients with primary systemic amyloidosis. ...
Amifostine and Melphalan in Treating Patients With Primary Systemic Amyloidosis Who Are Undergoing Peripheral Stem Cell Transplantation - Article Information
PubMed journal article: Multiple myeloma presenting with acquired cutis laxa and primary systemic amyloidosis. Download Prime PubMed App to iPhone, iPad, or Android
RATIONALE: Collecting and storing samples of blood, urine, and tissue from patients with primary systemic amyloidosis to test in the laboratory may help
Renal amyloidosis is a glomerulopathy resulting from glomerular deposition of insoluble fibrillar proteins in the mesangium of the glomerulus. Definition, classification, epidemiology, clinical presentation, diagnosis, and treatment of amyloidosis: see Amyloidosis.. Diagnosis is confirmed by the presence of amyloid protein on immunofluorescence and electron microscopy. Many different types of amyloid protein exist, but the two most common subtypes are AL and AA amyloid:. 1) AL amyloidosis is the most common renal amyloidosis. It results in organized deposits of light chains in the glomerulus. Renal involvement occurs in approximately 50% of patients and manifests as decreased renal function and proteinuria. Nephrotic syndrome can occur. Hypertension is usually absent and the kidneys are often enlarged. Renal treatment response is related to the degree of improvement in light chain production from the underlying condition. Proteinuria and renal function improve with successful therapy.. 2) AA ...
TY - JOUR. T1 - Successful sequential liver and stem cell transplantation for hepatic failure due to primary AL amyloidosis. AU - Kumar, K. Shiva. AU - Lefkowitch, Jay. AU - Russo, Mark W.. AU - Hesdorffer, Charles. AU - Kinkhabwala, Milan. AU - Kapur, Sandip. AU - Emond, Jean C.. AU - Brown, Robert S.. PY - 2002. Y1 - 2002. N2 - We report on a patient with primary AL amyloidosis who presented with progressive liver failure secondary to hepatic infiltration in the absence of significant extrahepatic involvement. Orthotopic liver transplantation was performed successfully. After an uneventful postoperative course, the patient developed evidence of significant recurrent amyloidosis requiring treatment. He then underwent stem cell transplantation 10 and 14 months after liver transplantation. After 28 months of follow-up posttransplantation, the patient continues to do well, with no clinical evidence of recurrent disease. This is the first reported patient with primary amyloidosis to undergo ...
High-dose melphalan with autologous stem cell transplantation (ASCT) can induce durable haematological and organ responses in systemic AL amyloidosis (AL). Stringent selection criteria have improved safety of ASCT in AL but most patients are transplant-ineligible. We report our experience of deferred ASCT in AL patients who were transplant-ineligible at presentation but had improvements in organ function after induction chemotherapy, enabling them to undergo ASCT. Twenty-two AL patients underwent deferred ASCT from 2011 to 2017. All had serial organ function and clonal response assessment. Organ involvement and responses were defined by amyloidosis consensus criteria. All patients were transplant-ineligible at presentation, predominantly due to advanced cardiac involvement. All received bortezomib-based therapy, with 100% haematologic response (86% complete response (CR)/very good partial response (VGPR)), enabling reversal of ASCT exclusion criteria. Patients underwent deferred ASCT for ...
TY - JOUR. T1 - Cardiac Light Chain Amyloidosis: The Role of Metal Ions in Oxidative Stress and Mitochondrial Damage. AU - Diomede, L.. AU - Romeo, M.. AU - Rognoni, P.. AU - Beeg, M.. AU - Foray, C.. AU - Ghibaudi, E.. AU - Palladini, G.. AU - Cherny, R. A.. AU - Verga, L.. AU - Capello, G. L.. AU - Perfetti, V.. AU - Fiordaliso, F.. AU - Merlini, G.. AU - Salmona, M.. N1 - LR: 20170920; JID: 100888899; OTO: NOTNLM; PMCR: 2018/09/20 00:00; 2018/09/20 00:00 [pmc-release]; 2017/01/31 06:00 [pubmed]; 2017/01/31 06:00 [medline]; 2017/01/31 06:00 [entrez]; ppublish. PY - 2017/9/20. Y1 - 2017/9/20. N2 - AIMS: The knowledge of the mechanism underlying the cardiac damage in immunoglobulin light chain (LC) amyloidosis (AL) is essential to develop novel therapies and improve patients outcome. Although an active role of reactive oxygen species (ROS) in LC-induced cardiotoxicity has already been envisaged, the actual mechanisms behind their generation remain elusive. This study was aimed at further ...
Protein aggregation is the cause of several human diseases such as diabetes mellitus type 2, Parkinson s disease, Alzheimer s disease, Huntington s disease, spongiform encephalopathies, congestive heart failure or dialysis-related amyloidosis. All of these disorders result from protein misfolding which leads to fibrillization and deposition of amyloid plaques in different parts of the body.Due to high molecular weight of the amyloid fibrils and intrinsic heterogeneity of the intermediate states, protein aggregation is a very challenging field of study for the structural biologist. However, nuclear magnetic resonance (NMR) provides a unique possibility to investigate aggregation at all stages, from the monomer to the fibrils.In this work, structural changes involved in prion diseases and dialysis-related amyloidosis are investigated with the help of various NMR techniques.Prion diseases are caused by the aggregation of the natively α-helical prion protein PrPC into its pathological β-sheet-rich ...
Chronic renal disease is a serious complication of long-term intravenous drug use (IVDU). Recent reports have postulated a changing pattern of underlying nephropathy over the last decades. Retrospective investigation including all patients with prior or present IVDU that underwent renal biopsy because of chronic kidney disease between 01.04.2002 and 31.03.2012 in the city of Frankfurt/Main, Germany. Twenty four patients with IVDU underwent renal biopsy because of progressive chronic kidney disease or proteinuria. Renal AA-amyloidosis was the predominant cause of renal failure in 50% of patients. Membranoproliferative glomerulonephritis (GN) was the second most common cause found in 21%. Patients with AA-amyloidosis were more likely to be HIV infected (67 vs.17%; p=0.036) and tended to have a higher rate of repeated systemic infections (92 vs. 50%; p=0.069). Patients with AA-amyloidosis presented with progressive renal disease and nephrotic-range proteinuria but most patients had no peripheral edema or
AL amyloidosis is caused by a clonal plasma cell dyscrasia and characterized by progressive deposition of amyloid fibrils derived from monoclonal Ig light chains, leading to multisystem organ failure and death. The prognosis for AL amyloidosis with conventional treatment remains poor, Autologous stem cell transplantation (ASCT) for AL amyloidosis produces high hematologic and organ responses. However, treatment-related mortality remains high and reported series are subject to selection bias ...
Amyloid diseases in man are caused by as many as 23 different pre-cursor proteins already described. Cardiologists predominantly encounter three main types of amyloidosis that affect the heart: light chain (AL) amyloidosis, senile systemic amyloidosis (SSA) and hereditary amyloidosis, most commonly caused by a mutant form of transthyretin. In the third world, secondary amyloid (AA) is more prevalent, due to chronic infections and inadequately treated inflammatory conditions. Much less common, are the non-transthyretin variants, including mutations of fibrinogen, the apolipoproteins apoA1 and apoA2 and gelsolin. These rarer types do not usually cause significant cardiac compromise. Occurring worldwide, later in life and of less clinical significance, isolated atrial amyloid (IAA) also involves the heart. Heart involvement by amyloid often has devastating consequences. Clinical outcome depends on amyloid type, the extent of systemic involvement and the treatment options available. An exact ...
Title. Using High-Dose Melphalan Plus Peripheral Stem Cell Transplantation to Treat Patients with Primary Systemic Amyloidosis (A Phase II Study). Sponsor. Eastern Cooperative Oncology Group through the NCI-sponsored Cancer Cooperative Group Program. Purpose of the Study. The purpose of this study was to evaluate the safety and effectiveness of high doses of the chemotherapy drug melphalan plus peripheral stem cell transplantation in treating patients who have primary systemic amyloidosis. Amyloidosis is a disease in which a certain type of protein is deposited in various organs, causing abnormal function. It can be caused by cancer or some other disease, or may have no known cause.. Results. The purpose of this study was to evaluate the safety and effectiveness of high doses of the chemotherapy drug melphalan plus peripheral stem cell transplantation in treating patients who have primary systemic amyloidosis. Amyloidosis is a disease in which a certain type of protein is deposited in various ...
The systemic amyloidoses are a number of disorders of varying etiology characterized by extracellular protein deposition. The most common form is an acquired amyloidosis secondary to multiple myeloma or monoclonal gammopathy of unknown significance (MGUS) in which the amyloid is composed of immunoglobulin light chains. In addition to light chain amyloidosis, there are a number of acquired amyloidoses caused by the misfolding and precipitation of a wide variety of proteins. There are also hereditary forms of amyloidosis.. The hereditary amyloidoses comprise a group of autosomal dominant, late-onset diseases that show variable penetrance. A number of genes have been associated with hereditary forms of amyloidosis, including those that encode transthyretin, apolipoprotein AI, apolipoprotein AII, fibrinogen alpha chain, gelsolin, cystatin C and lysozyme. Apolipoprotein AI, apolipoprotein AII, lysozyme, and fibrinogen amyloidosis present as non-neuropathic systemic amyloidosis, with renal dysfunction ...
A 62-year-old male smoker was reviewed for increasing dyspnoea, hoarseness and stridor. The patient underwent a bronchoscopic examination of the airway that revealed two large kissing fleshy tracheal lesions just below the vocal cords (figure 1). A biopsy was taken. The histological image (figure 2) was stained using a Congo Red Staining Kit which selectively demonstrates amyloid in the biopsy sample as bright pink and is marked A in the image. The darker coloured cells represent airway epithelium. Pulmonary amyloidosis is rare and patients may present with tracheobronchial infiltration, parenchymal infiltration (amyloidoma), persistent pleural effusions or pulmonary hypertension. Symptoms of tracheobronchial amyloidosis include hoarseness, stridor, dyspnoea and overt airway obstruction. Invasive bronchoscopic therapies such as argon photocoagulation, bronchoscopic Nd:YAG laser debulking or surgical debulking may be required to relieve the obstruction.1. ...
Familial renal amyloidosis (or familial visceral amyloidosis, or hereditary amyloid nephropathy) is a form of amyloidosis primarily presenting in the kidney. It is associated most commonly with congenital mutations in the fibrinogen alpha chain and classified as a dysfibrinogenemia (see Hereditary Fibrinogen Aα-Chain Amyloidosis). and, less commonly, with congenital mutations in apolipoprotein A1 and lysozyme. It is also known as "Ostertag" type, after B. Ostertag, who characterized it in 1932 and 1950. "Amyloid". Gillmore JD, Lachmann HJ, Rowczenio D, Gilbertson JA, Zeng CH, Liu ZH, Li LS, Wechalekar A, Hawkins PN (2009). "Diagnosis, pathogenesis, treatment, and prognosis of hereditary fibrinogen A alpha-chain amyloidosis". Journal of the American Society of Nephrology : JASN. 20 (2): 444-51. doi:10.1681/ASN.2008060614. PMC 2637055 . PMID 19073821. Uemichi T, Liepnieks JJ, Gertz MA, Benson MD (September 1998). "Fibrinogen A alpha chain Leu 554: an African-American kindred with late onset renal ...
Results were recently published for the first trial of CPHPC as a therapy to clear out age-related deposits of the type of amyloid formed from misfolded transthyretin, normally responsible for transporting the thyroid hormone thyroxine in blood and cerebrospinal fluid. Amyloids are one of the distinguishing features of older tissues, and clearing them will be one of the necessary outcomes produced by any comprehensive suite of rejuvenation therapies developed in the near future.. The accumulation of transthyretin amyloid creates a condition known as senile systemic amyloidosis where it occurs to varying degrees for everyone in later life, and TTR amyloidosis when it arises in young people due to inherited mutations. Senile systemic amyloidosis is known to be responsible for a sizable fraction of deaths in supercentenarians, as the amyloid deposits clog the cardiovascular system to the point of failure. This process is also thought to play an underappreciated role in heart failure in the younger ...
Background: Cardiac involvement in primary amyloidosis (AL) is associated with poor prognosis. We studied the prognostic significance of clinical, ECG and echocardiographic parameters of patients with primary cardiac amyloidosis.. Methods: 60 patients with primary amyloidosis and cardiac involvement documented by endomyocardial tissue biopsy were studied.. Results: 60 patients (mean age 57.94±10.22 years; 71.67% male and 86.67% Caucasian) were studied. The median survival was 12.23 (median) ±4.43 months, 50% of patients survived for more than 1 year. Congestive heart failure (NYHA II-IV) was present in 60% of patients. Low voltage, Q wave, conduction abnormalities, first degree AV block and abnormal QRS axis were present in 54.24%, 51.72%, 71.67%, 21.67% and 57.72% respectively. Echocardiogram revealed LVH, mitral regurgitation, left atrial enlargement, speckled appearance and pericardial effusion in 82.76%, 62%, 63.16%, 8.77% and 42.11% respectively. LVEF, RVSP, IVS and LVPW were 0.479±.129, ...
TY - JOUR. T1 - Persistent fever and destructive arthritis caused by dialysis-related amyloidosis. AU - Matsumoto, Kotaro. AU - Kikuchi, Jun. AU - Kaneko, Yuko. AU - Yasuoka, Hidekata. AU - Suzuki, Kazuko. AU - Tokuyama, Hirobumi. AU - Kameyama, Kaori. AU - Yamaoka, Kunihiro. AU - Takeuchi, Tsutomu. PY - 2018/1/1. Y1 - 2018/1/1. N2 - Rationale: Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes. Patient concerns: A 64-year-old man on hemodialysis for ,30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years. Several antibiotics were ineffective for 3 months before his admission. On physical examination, joint swelling was observed at bilateral wrists, knees, ...
Results The direct numeric result from hs-cTnT measurement cannot merely be substituted for a cTnT measurement in the Mayo AL staging system. The performance of the receiver operator curve derived an hs-cTnT cut-point of 54 ng/L which improves on the value of 35 ng/L validated with the prior iteration of the assay. An alternate staging option using hs-cTnT alone-using the two thresholds 14 ng/L and 54 ng/L-performs as well as either the original Mayo AL staging system or other systems incorporating hs-cTnT. On multivariate analysis, an hs-cTnT alone staging system was independent of period of diagnosis, type of therapy, and NT-proBNP value, the last of which dropped out of the model. Alternate models were explored, but none performed better than the original system or the new hs-cTnT system. Thus, hs-cTnT can be used alone for the staging of disease prognosis.. ...
So why do I think all of this is predatory in nature? I receive this bill every 20 days, the same bill, and my husband and I make the required phone calls to the medical facility and the primary insurance company. So far neither institution has been able to resolve this claim. If we failed to make these phone calls every 20 days this bill, in all likelihood, would go to collection and could balloon to twice what it is now with fees and interest. That being said, in this case the medical facility actually owns the collection agency that these bills go to so they not only get to collect the amount of the bill, but the fees and interest as well. That doesnt sound shady at all does it?. What most people dont know or dont care to take advantage of is that if you call the medical facility that has sent you a bill to make payment arrangements or to dispute the charges they, in most circumstances, will not send you to collection; however, you have to call them EVERY TIME you receive the same bill. ...
... refers to a group of conditions in which proteins (amyloids) accumulate in the bodys organs and tissues in abnormal amounts, disrupting normal functions. Amyloidosis may be caused by a bone marrow cell disorder or an inherited protein variation. Or it may be associated with other conditions, including chronic infections or chronic inflammatory diseases.. Organs most often affected by amyloidosis include the heart, liver, kidney, skin, and certain nerves. But any organ system may be involved. Symptoms of amyloidosis depend upon the organ system affected and may not help determine what condition is causing the protein accumulation. Amyloidosis can be disabling and even life-threatening.. Treatment of amyloidosis depends upon the condition that is causing the protein accumulation. Treatment options may include medicine or stem cell transplant.. ...
TY - JOUR. T1 - Colchicine therapy of the renal amyloidosis of ulcerative colitis. AU - Meyers, Samuel. AU - Janowitz, Henry D.. AU - Gumaste, Vivek V.. AU - Abramson, Ruth G.. AU - Berman, Laurence J.. AU - Venkataseshan, V. S.. AU - Dickman, Steven H.. PY - 1988/6. Y1 - 1988/6. N2 - Two patients with severe proteinuria, due to renal amyloidosis complicating chronic ulcerative colitis, improved remarkably with colchicine therapy. One patient with an initial daily urine protein excretion of 13.70 g had a reduction within 2 mo to 6.50 g and to 0.37 g after 9 yr. The other patients daily urine protein excretion was 9.00 g. This was reduced to 5.10 g/day within 3 mo and was 0.53 g/day by 8 mo. Renal function remained stable or improved during the period of therapy. Colchicine resulted in rapid and prolonged benefit for these patients, despite their amyloid-induced nephrotic syndrome.. AB - Two patients with severe proteinuria, due to renal amyloidosis complicating chronic ulcerative colitis, ...
The cause of the electrocardiographic abnormalities in amyloidosis is a matter of controversy despite attempts of clinicopathological correlation. Detailed correlative studies of the involvement of cardiac conduction system in amyloidosis are few and have produced conflicting results. Some authors favour the hypothesis that infiltration of the conducting system by amyloid deposits is the main reason for the disturbances of conduction [19]. In familial amyloidosis with polyneuropathy, amyloid infiltration of the sinus node and atrioventricular conduction system is now well documented, and this seems to account for the majority of the electrophysiological disturbances of these regions [20, 21, 22].The distribution and extent of heart infiltration by amyloid are not, however, uniform. On the other hand, other authors have concluded that direct infiltration by amyloid is of lesser importance [14]. Autonomous neuropathy due to amyloid may also contribute to the electrophysiological disturbances. In ...
TY - JOUR. T1 - Primary amyloidosis-induced nail dystrophy. AU - Tausend, William. AU - Neill, Megan. AU - Kelly, Brent. PY - 2014/1/27. Y1 - 2014/1/27. N2 - Primary amyloidosis is caused by a monoclonal proliferation of plasma cells and is capable of producing cutaneous lesions. A 56- year-old male was admitted to the hospital for evaluation of chronic back pain and acute lower extremity weakness. On examination, he was noted to have subungual verrucous plaques with overlying nail dystrophy on his bilateral thumbs. A biopsy of one subungual lesion showed a deposition of amorphous material in the dermis that stained with Congo red and crystal violet. These cutaneous lesions ultimately led to the diagnosis of plasma cell dyscrasia and primary amyloidosis. Based on the literature search, primary amyloidosis presenting with this degree of subungual thickening and overlying nail dystrophy has not been previously reported.. AB - Primary amyloidosis is caused by a monoclonal proliferation of plasma ...
This is the first reported case of familial amyloid cardiomyopathy associated with TTR Ile122 in a white patient. The Ile122 mutation is present in 4% of African Americans and usually results in isolated cardiac amyloidosis from age 60 years onwards, presenting with cardiac failure and/or arrhythmia. Occasionally, there is associated carpal tunnel syndrome, and peripheral polyneuropathy has been reported.3 Amyloid deposits of wild-type TTR are found in 25% of hearts from people over 80 years old, examined after death.6 These deposits do not always cause clinical symptoms but the possibility of amyloidosis should be considered when treating elderly patients with heart failure, particularly in cases resistant to conventional treatment with diuretics and ACE inhibitors. The diagnosis of cardiac amyloidosis is suggested by an ECG showing small complexes and/or anterior Q waves in association with concentric left ventricular hypertrophy or restrictive physiology and occasionally a speckled myocardium ...
There is no detailed description of the clinical characteristics of patients with RA before the onset of intractable diarrhoea associated with secondary amyloidosis in previous case reports.14-17 Our present retrospective study showed that before the onset of diarrhoea, most patients showed high activity of arthritis and repeated prodromal gastrointestinal symptoms. Furthermore, some cases showed possible causes of induction of intractable diarrhoea (that is, operation, infection or extraarticular manifestation). SAA, which is the precursor of amyloid A protein, is known to be synthesised in the liver and the process is stimulated by macrophage derived cytokines such as interleukin 1, interleukin 6 or tumour necrosis factor, thus it rapidly increases in blood at the time of acute inflammation in parallel with acute phase proteins such as C reactive protein.20 It is considered that high activity of arthritis, infection, surgery and extraarticular manifestation of RA induce a rapid increase of SAA ...
Before taking the steps to participate in any of our research projects, please read the article here.. Amyloidosis. Lead contact: Maria Longeri - University of Milan ([email protected]). Introduction. Amyloidosis is characterized by abnormal deposits of a protein complex (amyloid) in tissues and organs, which affects their functions and eventually can lead to organ failure and death. It occurs in both wild and domestic felids, including random-bred cats. Amyloidosis is well known as a familial trait in the Abyssinian/Somali breeds that mainly affects the kidneys, and in the Siamese/Oriental breeds that mainly affects the liver.. In humans, several types of amyloidosis exist and are associated with myeloma, Alzheimers disease, and chronic inflammatory diseases. Single genes have also been identified as causes for different inherited forms of amyloidosis. Therefore, Feline Amyloidosis is an interesting model for understanding the cause and development of the similar human ...
Primary amyloidosis is a systemic disorder caused by the clonal production and tissue deposition of immunoglobulin light chain proteins. The disease symptoms are typical of multisystem failure. Common presenting features include nephrotic syndrome, hepatomegaly, sensomotor peripheral neuropathy and, in the case of cardiac involvement, congestive heart failure. This last sign appears very seldom as alone, without any others. Cardiac involvement generally denotes a poor prognosis, regardless of the method of treatment. The median survival rate from onset of congestive heart failure is 6 months. Only the patients with earliest diagnosis made and advanced treatment (chemotherapy, autologous stem-cell transplantation, heart transplantation) introduced have the chance of the lengthening of life. The authors present a case of 52-year-old man with a primary amyloidosis, who suffered from severe, not responding to treatment, congestive heart failure. Because of lack of the other organ involvement ...
DIAGNOSIS. A thorough physical exam and a detailed and accurate account of your medical history are crucial in helping your doctor diagnose amyloidosis. Sophisticated laboratory techniques called electrophoresis or free light chain assays may reveal early evidence of some amyloid proteins.. A diagnosis of amyloidosis is confirmed through biopsy. Biopsy can also determine the specific type of protein involved in the disease.. Genetic testing will be done if your health care provider suspects you have a type that is passed down through families. Treatment for hereditary amyloidosis is different than for other types of the disease.. Other blood, urine, and imaging tests will be done to check organ function.. RECOMMENDED MEDICATIONS. There is no cure for amyloidosis. Your doctor will prescribe treatments to suppress the development of the amyloid-forming protein, and to manage your symptoms. If amyloidosis is related to another condition, then treatment will include targeting that underlying ...