Amyloidosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory findings in amyloidosis include an elevated erythrocyte sedimentation rate and an increased BUN level. Serum creatinine, protein, casts, or fat bodies can also be found in the 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. Amyloid deposits are easily recognized because they produce a distinctive 'apple green birefringence'. Alternatively, a thioflavin T stain may be used. Also, an abdominal fat pad aspiration, rectal mucosa biopsy, or bone marrow biopsy can help confirm the diagnosis. These tests reveal positive findings in 80% of patients.

Laboratory Findings

• Complete blood count - may reveal anemia.
• Erythrocyte sedimentation rate - elevated
• Liver function tests
  • Serum albumin
  • Alkaline phosphatase
  • Bilirubin, total
• Kidney function tests may show signs of kidney failure or too much protein in the urine (nephrotic syndrome).
  • BUN level is increased.
  • Serum creatinine is increased.
  • Urinalysis shows protein, casts, or fat bodies.
  • Bence-Jones protein (quantitative)
• Serum troponin, B-type natriuretic peptide, and beta-2-microglobulin - prognostic markers for heart failure.
• Immunoelectrophoresis - serum
• 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
• Immunohistochemical studies on the amyloid deposits - to differentiate from different types of amyloid.
• Biopsy - is needed depending on the involvement of the specific organ. e.g tongue, myocardium, skin. An abdominal fat pad aspiration, rectal mucosa biopsy, or bone marrow biopsy can help confirm the diagnosis. They reveal positive findings in 80% patients.