In order to assess the prevalence of the carpal tunnel syndrome (CTS) suggestive of beta 2 microglobulin amyloid deposit in patients undergoing hemodialysis with cuprophan and acetate membrane, we studied 30 patients who had been receiving hemodialysis for varying lengths of time. Besides a standard physical and rheumatological examination, nerve conduction velocity studies were done in median and ulnar motorsensory nerves. 12 patients had normal findings, 12 had CTS (9 pure CTS, 3 with neuropathy), and 9 had peripheral neuropathy. Nerve dysfunction was independent of the disease underlying renal failure, the side of the dialysis access shunt and factors such as age and sex. We suggest that hemodialysis patients need frequent EMG analysis to identify CTS early and to avoid irreversible nerve damage.

Systemic AA type amyloidosis with renal involvement is the major cause of morbidity and mortality in patients with familial Mediterranean fever (FMF). A histopathological examination is essential to achieve a definite diagnosis in systemic amyloidosis. The diagnostic yield of the procedure varies according to the biopsy site and renal biopsy has the highest yield. On the other hand this procedure has its own complications and requires hospitalization of the patient. Alternative biopsy sites have been proposed with varying degrees of sensitivity and morbidity to reduce the morbidity and mortality of solid organ biopsies. We performed bone marrow biopsies in 39 patients with FMF who had different stages of renal disease. Thirty-one (79.5%) of the 39 specimens showed significant perivascular amyloid infiltration when stained with crystal violet and Congo red. An immunoperoxidase stain with a monoclonal antibody proved that these deposits were AA type amyloid. We suggest that bone marrow biopsy can be utilized for a safe and quick diagnosis of systemic amyloidosis in patients with FMF and renal disease.

A case of hydatid disease of the intra and parasacral area is reported. This rare localization was probably due to previous abdominal hydatid cyst surgery. The patient underwent surgery, with a small opening in the SI lamina and the cysts were removed totally with the aid of a rigid endoscope. The surgical technique used and MRI findings are discussed.

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