Cardiac amyloidosis laboratory findings: Difference between revisions
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* Serum [[troponin]]s: Cardiac troponins are elevated due to myonecrosis and small-vessel disease due to deposition of amyloid in the heart. Troponins are of both diagnostic and prognostic importance. Studies have shown worse survival rates in patients with systemic amyloidosis and cardiac involvement compared to those without cardiac involvement.<ref name="pmid12781539">{{cite journal |author=Dispenzieri A, Kyle RA, Gertz MA, ''et al.'' |title=Survival in patients with primary systemic amyloidosis and raised serum cardiac troponins |journal=[[Lancet]] |volume=361 |issue=9371 |pages=1787–9 |year=2003 |month=May |pmid=12781539 |doi=10.1016/S0140-6736(03)13396-X |url=}}</ref> | * Serum [[troponin]]s: Cardiac troponins are elevated due to myonecrosis and small-vessel disease due to deposition of amyloid in the heart. Troponins are of both diagnostic and prognostic importance. Studies have shown worse survival rates in patients with systemic amyloidosis and cardiac involvement compared to those without cardiac involvement.<ref name="pmid12781539">{{cite journal |author=Dispenzieri A, Kyle RA, Gertz MA, ''et al.'' |title=Survival in patients with primary systemic amyloidosis and raised serum cardiac troponins |journal=[[Lancet]] |volume=361 |issue=9371 |pages=1787–9 |year=2003 |month=May |pmid=12781539 |doi=10.1016/S0140-6736(03)13396-X |url=}}</ref> | ||
* [[Atrial natriuretic peptide]]: Elevated in heart failure | * [[Atrial natriuretic peptide]]: Elevated in heart failure | ||
* [[Brain natriuretic peptide]]: Elevated in heart failure. N-terminal proBNP is the most sensitive marker of heart dysfunction in amyloid patients.<ref name="pmid16434487">{{cite journal |author=Palladini G, Lavatelli F, Russo P, ''et al.'' |title=Circulating amyloidogenic free light chains and serum N-terminal natriuretic peptide type B decrease simultaneously in association with improvement of survival in AL |journal=[[Blood]] |volume=107 |issue=10 |pages=3854–8 |year=2006 |month=May |pmid=16434487 |doi=10.1182/blood-2005-11-4385 |url=}}</ref> | * [[Brain natriuretic peptide]]: Elevated in heart failure. N-terminal proBNP is the most sensitive marker of heart dysfunction in amyloid patients. BNP levels may be seen elevated even before the onset of clinical heart failure. It is suggested that myocyte damage caused by extracellular deposition of amyloid is the reason for this finding.<ref name="pmid16434487">{{cite journal |author=Palladini G, Lavatelli F, Russo P, ''et al.'' |title=Circulating amyloidogenic free light chains and serum N-terminal natriuretic peptide type B decrease simultaneously in association with improvement of survival in AL |journal=[[Blood]] |volume=107 |issue=10 |pages=3854–8 |year=2006 |month=May |pmid=16434487 |doi=10.1182/blood-2005-11-4385 |url=}}</ref><ref name="pmid16188528">{{cite journal |author=Nordlinger M, Magnani B, Skinner M, Falk RH |title=Is elevated plasma B-natriuretic peptide in amyloidosis simply a function of the presence of heart failure? |journal=[[The American Journal of Cardiology]] |volume=96 |issue=7 |pages=982–4 |year=2005 |month=October |pmid=16188528 |doi=10.1016/j.amjcard.2005.05.057 |url=}}</ref> | ||
* Serum [[transthyretin]] | * Serum [[transthyretin]] | ||
* Urinalysis for [[proteinuria]] | * Urinalysis for [[proteinuria]] | ||
Revision as of 23:43, 4 May 2013
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Cardiac amyloidosis Microchapters |
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Cardiac amyloidosis laboratory findings On the Web |
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Risk calculators and risk factors for Cardiac amyloidosis laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]; Aarti Narayan, M.B.B.S [3]; Lakshmi Gopalakrishnan, M.B.B.S. [4]
Overview
There is no specific diagnostic blood test, radiograph, or scan that can be used to diagnose amyloidosis; hence, awareness of the disease is necessary to identify patients with amyloidosis.[1]
Laboratory Findings
The following are the laboratory tests included in the management of cardiac amyloidosis:
- Complete blood count: Normocytic normochromic anemia may be present
- Serum troponins: Cardiac troponins are elevated due to myonecrosis and small-vessel disease due to deposition of amyloid in the heart. Troponins are of both diagnostic and prognostic importance. Studies have shown worse survival rates in patients with systemic amyloidosis and cardiac involvement compared to those without cardiac involvement.[2]
- Atrial natriuretic peptide: Elevated in heart failure
- Brain natriuretic peptide: Elevated in heart failure. N-terminal proBNP is the most sensitive marker of heart dysfunction in amyloid patients. BNP levels may be seen elevated even before the onset of clinical heart failure. It is suggested that myocyte damage caused by extracellular deposition of amyloid is the reason for this finding.[3][4]
- Serum transthyretin
- Urinalysis for proteinuria
- Serum and urine electrophoresis
- Serum and urine immunofixation
- Serum electrolytes
References
- ↑ Hawkins PN (1997). "The diagnosis, natural history and treatment of amyloidosis. The Goulstonian Lecture 1995". Journal of the Royal College of Physicians of London. 31 (5): 552–60. PMID 9429195.
|access-date=requires|url=(help) - ↑ Dispenzieri A, Kyle RA, Gertz MA; et al. (2003). "Survival in patients with primary systemic amyloidosis and raised serum cardiac troponins". Lancet. 361 (9371): 1787–9. doi:10.1016/S0140-6736(03)13396-X. PMID 12781539. Unknown parameter
|month=ignored (help) - ↑ Palladini G, Lavatelli F, Russo P; et al. (2006). "Circulating amyloidogenic free light chains and serum N-terminal natriuretic peptide type B decrease simultaneously in association with improvement of survival in AL". Blood. 107 (10): 3854–8. doi:10.1182/blood-2005-11-4385. PMID 16434487. Unknown parameter
|month=ignored (help) - ↑ Nordlinger M, Magnani B, Skinner M, Falk RH (2005). "Is elevated plasma B-natriuretic peptide in amyloidosis simply a function of the presence of heart failure?". The American Journal of Cardiology. 96 (7): 982–4. doi:10.1016/j.amjcard.2005.05.057. PMID 16188528. Unknown parameter
|month=ignored (help)