- diagnosis made by biopsy of affected tissue and positive Congo Red staining with red green birefringence under polarised light microscopy. Rectum or subcutaneous fat are relatively non-invasive site for biopsy
Primary amyloidosis (AL amyloidosis)
- in lymphoproliferative disorder (myeloma, MGUS, non-Hodgkin lymphoma), clonal plasma cells in bone marrow produce immunoglobulins that are amyloidogenic
- presents with nephrotic syndrome, cardiomyopathy (avoid digoxin), autonomic and sensory neuropathies, hepatomegaly, periorbital purpura and macroglossia
- echo : 'sparkling' appearance (restrictive cardiomyopathy)
Familial amyloidosis (transthyretin-associated)
- autosomal dominant
- renal disease less prevalent than AL amyloidosis and macroglossia does not occur
Reactive amyloidosis (AA amyloidosis)
- formed from serum amyloid A (SAA), which is an acute phase protein
- occurs in chronic inflammatory disorder
- presents with nephrotic syndrome, hepatomegaly and splenomegaly, cardiac involvement is much less common
ReplyDeleteI was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.