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==Overview== | ==Overview== | ||
Laboratory findings | Laboratory findings in amyloidosis include elevated [[erythrocyte sedimentation rate]], increased [[BUN]] level, serum [[creatinine]], protein, casts, or fat bodies in urine. Serum [[troponin]], [[B-type natriuretic peptide]], and [[beta-2-microglobulin]] are prognostic markers for [[heart failure]]. Amyloid deposits can be identified [[histologically]] by [[Congo red]] staining and viewing under [[polarized light]] where amyloid deposits produce a distinctive 'apple green birefringence'. Alternatively, [[Thioflavin|thioflavin T]] stain may be used. An abdominal fat pad aspiration, rectal mucosa biopsy, or bone marrow biopsy can help confirm the diagnosis. They reveal positive findings in 80% patients. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
** Troponin I or Troponin T | === '''Cardiac''' === | ||
* [[Cardiac biomarkers]] are the most important predictors of outcome in amyloidosis. | |||
* They provide a quantitative assessment for [[Heart|cardiac]] damage and wall strain.<ref name="pmid21483018">{{cite journal |vauthors=Merlini G, Seldin DC, Gertz MA |title=Amyloidosis: pathogenesis and new therapeutic options |journal=J. Clin. Oncol. |volume=29 |issue=14 |pages=1924–33 |date=May 2011 |pmid=21483018 |pmc=3138545 |doi=10.1200/JCO.2010.32.2271 |url=}}</ref> | |||
* The biomarkers include: | |||
:* Troponin I or Troponin T | |||
:* BNP and NT-proBNP | |||
* | === '''Hepatic''' === | ||
* | |||
* | * [[Liver function tests]], including: | ||
* | |||
:*AST | |||
:*ALT | |||
:*Total bilirubin | |||
:*Alkaline phosphatase | |||
* | :*Albumin | ||
* | |||
* | === '''Renal''' === | ||
* | |||
* A variety of kidney function tests can suggest amyloidosis. | |||
* These [[Test|tests]] include abnormalities in: | |||
:*[[Creatinine|Serum creatinine]] | |||
:*[[Urinary]] [[protein]] | |||
:*[[Glomerular filtration rate]] | |||
:*[[Albumin]] to [[creatinine]] ratio in the [[urine]] | |||
=== '''Thyroid''' === | |||
* Common [[Test|tests]] that are abnormal in thyroidal involvement of amyloidosis include: | |||
:*TSH | |||
:*Free T4 | |||
=== '''Bone marrow''' === | |||
* Concurrent [[multiple myeloma]] can be found in [[Patient|patients]] with amyloidosis. | |||
* In such cases, [[laboratory]] [[Test|testing]] should include<ref name="pmid24145344">{{cite journal| author=Kourelis TV, Kumar SK, Gertz MA, Lacy MQ, Buadi FK, Hayman SR et al.| title=Coexistent multiple myeloma or increased bone marrow plasma cells define equally high-risk populations in patients with immunoglobulin light chain amyloidosis. | journal=J Clin Oncol | year= 2013 | volume= 31 | issue= 34 | pages= 4319-24 | pmid=24145344 | doi=10.1200/JCO.2013.50.8499 | pmc=4881366 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24145344 }} </ref>: | |||
:*[[Serum protein electrophoresis]] | |||
:*[[Immunoglobulin]] levels | |||
:*[[Serum]] free light chains | |||
:*[[Beta-2 microglobulin|Beta-2-microglobulin]] | |||
== References == | == References == | ||
Latest revision as of 01:34, 26 October 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[3]
Overview
Laboratory findings in amyloidosis include elevated erythrocyte sedimentation rate, increased BUN level, serum creatinine, protein, casts, or fat bodies in urine. Serum troponin, B-type natriuretic peptide, and beta-2-microglobulin are prognostic markers for heart failure. Amyloid deposits can be identified histologically by Congo red staining and viewing under polarized light where amyloid deposits produce a distinctive 'apple green birefringence'. Alternatively, thioflavin T stain may be used. An abdominal fat pad aspiration, rectal mucosa biopsy, or bone marrow biopsy can help confirm the diagnosis. They reveal positive findings in 80% patients.
Laboratory Findings
Cardiac
- Cardiac biomarkers are the most important predictors of outcome in amyloidosis.
- They provide a quantitative assessment for cardiac damage and wall strain.[1]
- The biomarkers include:
- Troponin I or Troponin T
- BNP and NT-proBNP
Hepatic
- Liver function tests, including:
- AST
- ALT
- Total bilirubin
- Alkaline phosphatase
- Albumin
Renal
- A variety of kidney function tests can suggest amyloidosis.
- These tests include abnormalities in:
- Serum creatinine
- Urinary protein
- Glomerular filtration rate
- Albumin to creatinine ratio in the urine
Thyroid
- Common tests that are abnormal in thyroidal involvement of amyloidosis include:
- TSH
- Free T4
Bone marrow
- Concurrent multiple myeloma can be found in patients with amyloidosis.
- In such cases, laboratory testing should include[2]:
- Serum protein electrophoresis
- Immunoglobulin levels
- Serum free light chains
- Beta-2-microglobulin
References
- ↑ Merlini G, Seldin DC, Gertz MA (May 2011). "Amyloidosis: pathogenesis and new therapeutic options". J. Clin. Oncol. 29 (14): 1924–33. doi:10.1200/JCO.2010.32.2271. PMC 3138545. PMID 21483018.
- ↑ Kourelis TV, Kumar SK, Gertz MA, Lacy MQ, Buadi FK, Hayman SR; et al. (2013). "Coexistent multiple myeloma or increased bone marrow plasma cells define equally high-risk populations in patients with immunoglobulin light chain amyloidosis". J Clin Oncol. 31 (34): 4319–24. doi:10.1200/JCO.2013.50.8499. PMC 4881366. PMID 24145344.