Amyloidosis

Amyloidosis

Amyloidosis	The definitive test is the demonstration of amyloid in a tissue biopsy , using special stains, IF and EM. Ideally, biopsy of an affected organ (eg liver, kidney) should be performed. If no specific site can be identified, colorectal biopsy or gingival biopsy may demonstrate amyloid. Further tests may assist in determining nature and cause: FBC , CRP or ESR , protein electrophoresis - serum , protein electrophoresis - urine ; paraprotein typing - serum if an immunoglobulin origin is suspected; immunoglobulins G, A, M ; bone marrow aspiration and trephine biopsy . Creatinine, urea, protein (urine) to assess renal involvement.
Immunoglobulin origin
Primary amyloidosis
Multiple myeloma
Amyloid A origin
Chronic inflammation esp
Chronic infection
Rheumatoid arthritis
Familial Mediterranean fever
Pre-albumin origin
Familial amyloid polyneuropathy	Molecular genetics , if available.
b2-microglobulin origin Dialysis-associated	Beta-2-microglobulin - serum .
Localised deposition
Cerebral
Alzheimer’s disease	See under Dementia .
Laryngeal
Bladder
Tumour associated eg
Medullary carcinoma of thyroid	See under Thyroid nodule/cyst .
Senile eg
Cardiac
Cerebral