Secondary amyloidosis other diagnostic studies: Difference between revisions
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==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
* A tissue [[biopsy]] or fat [[aspirate]] should be done to confirm the presence or type of [[amyloid]] protein which is involved in the [[pathogenesis]] of the disease.<ref name="pmid24497558">{{cite journal |vauthors=Mahmood S, Palladini G, Sanchorawala V, Wechalekar A |title=Update on treatment of light chain amyloidosis |journal=Haematologica |volume=99 |issue=2 |pages=209–21 |date=February 2014 |pmid=24497558 |pmc=3912950 |doi=10.3324/haematol.2013.087619 |url=}}</ref> | * A tissue [[biopsy]] or fat [[aspirate]] should be done to confirm the presence or type of [[amyloid]] protein which is involved in the [[pathogenesis]] of the disease.<ref name="pmid24497558">{{cite journal |vauthors=Mahmood S, Palladini G, Sanchorawala V, Wechalekar A |title=Update on treatment of light chain amyloidosis |journal=Haematologica |volume=99 |issue=2 |pages=209–21 |date=February 2014 |pmid=24497558 |pmc=3912950 |doi=10.3324/haematol.2013.087619 |url=}}</ref> | ||
* To obtain a sample for histologic examination, multiple anatomical places have been used so far. | |||
* In 1960s, gingival and mucosa biopsy were the anatomic places of choice, but they were now replaced by other more accessible places. | |||
* Table below compares the recommended anatomical places.<ref name="Real de AsuaGalvan2014">{{cite journal|last1=Real de Asua|first1=Diego|last2=Galvan|first2=Jose Maria|last3=Filigghedu|first3=Maria Teresa|last4=Trujillo|first4=Davinia|last5=Costa|first5=Ramon|last6=Cadinanos|first6=Julen|title=Systemic AA amyloidosis: epidemiology, diagnosis, and management|journal=Clinical Epidemiology|year=2014|pages=369|issn=1179-1349|doi=10.2147/CLEP.S39981}}</ref> | |||
* It is of particular note that, a negative biopsy result for amyloid deposition would not exclude the diagnosis of amyloidosis, especially in the presence of high clinical suspicion. | |||
{| | |||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity | |||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity | |||
|- | |||
! style="background: #696969; color: #FFFFFF; text-align: center;" |Subcutaneous abdominal fat tissue aspiration | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |57%–82% | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |93%–100% | |||
|- | |||
! style="background: #696969; color: #FFFFFF; text-align: center;" |Rectal mucosa biopsy | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |75%–85% | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |_ | |||
|- | |||
! style="background: #696969; color: #FFFFFF; text-align: center;" |Minor salivary gland biopsy | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |83%–100% | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |_ | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 22:38, 10 November 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
A tissue biopsy or fat aspirate should be done to confirm the presence or type of amyloid protein which is involved in the pathogenesis of the disease.
Other Diagnostic Studies
- A tissue biopsy or fat aspirate should be done to confirm the presence or type of amyloid protein which is involved in the pathogenesis of the disease.[1]
- To obtain a sample for histologic examination, multiple anatomical places have been used so far.
- In 1960s, gingival and mucosa biopsy were the anatomic places of choice, but they were now replaced by other more accessible places.
- Table below compares the recommended anatomical places.[2]
- It is of particular note that, a negative biopsy result for amyloid deposition would not exclude the diagnosis of amyloidosis, especially in the presence of high clinical suspicion.
| Test | Sensitivity | Specificity |
|---|---|---|
| Subcutaneous abdominal fat tissue aspiration | 57%–82% | 93%–100% |
| Rectal mucosa biopsy | 75%–85% | _ |
| Minor salivary gland biopsy | 83%–100% | _ |
References
- ↑ Mahmood S, Palladini G, Sanchorawala V, Wechalekar A (February 2014). "Update on treatment of light chain amyloidosis". Haematologica. 99 (2): 209–21. doi:10.3324/haematol.2013.087619. PMC 3912950. PMID 24497558.
- ↑ Real de Asua, Diego; Galvan, Jose Maria; Filigghedu, Maria Teresa; Trujillo, Davinia; Costa, Ramon; Cadinanos, Julen (2014). "Systemic AA amyloidosis: epidemiology, diagnosis, and management". Clinical Epidemiology: 369. doi:10.2147/CLEP.S39981. ISSN 1179-1349.