Effect of synovial transthyretin amyloid deposition on preoperative symptoms and postoperative recovery of median nerve function among patients with idiopathic carpal tunnel syndrome

Uchiyama, Shigeharu; Sekijima, Yoshiki; Tojo, Koji; Sakai, Kenji; Imaeda, Toshihiko; Moriizumi, Tetsuji; Ikeda, Shu‐ichi; Kato, Hiroyuki

doi:10.1007/s00776-014-0635-y

Cited by 10 publications

(2 citation statements)

References 30 publications

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“…Cases have been reported in which carpal tunnel release did not relieve symptoms. 19 Nerve conduction studies in patients with ATTRv have demonstrated abnormalities in the median nerve, signifying that CTS may not be just a simple entrapment injury. 20 In general, CTS is relatively less common in AL than in ATTR, but it is still experienced by a substantial number of patients.…”

Section: Clinical Presentation and Pathophysiology Of Amyloid Deposition In Musculoskeletal Connective Tissue (Fig 1)mentioning

confidence: 99%

Carpal Tunnel Syndrome: A Potential Early, Red-Flag Sign of Amyloidosis

Donnelly

Hanna

Sperry

et al. 2019

The Journal of Hand Surgery

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Carpal tunnel syndrome (CTS) can be caused by the deposition and accumulation of misfolded proteins called amyloid and is often an early manifestation of systemic amyloidosis. In patients undergoing surgery for idiopathic CTS, a recent study identified amyloidosis by tenosynovial biopsy in 10.2% of men older than 50 years and women older than 60 years; all positive patients had bilateral symptoms. These findings have led to a renewed interest in CME INFORMATION AND DISCLOSURESThe Journal of Hand Surgery will contain at least 2 clinically relevant articles selected by the editor to be offered for CME in each issue. For CME credit, the participant must read the articles in print or online and correctly answer all related questions through an online examination. The questions on the test are designed to make the reader think and will occasionally require the reader to go back and scrutinize the article for details.The JHS CME Activity fee of $15.00 includes the exam questions/answers only and does not include access to the JHS articles referenced.Statement of Need: This CME activity was developed by the JHS editors as a convenient education tool to help increase or affirm reader's knowledge. The overall goal of the activity is for participants to evaluate the appropriateness of clinical data and apply it to their practice and the provision of patient care. Accreditation:The American Society for Surgery of the Hand (ASSH) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.AMA PRA Credit Designation: The ASSH designates this Journal-Based CME activity for a maximum of 1.00 AMA PRA Category 1 Creditsä. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Section: Clinical Presentation and Pathophysiology Of Amyloid Deposition In Musculoskeletal Connective Tissue (Fig 1)mentioning

confidence: 99%

Carpal Tunnel Syndrome: A Potential Early, Red-Flag Sign of Amyloidosis

Donnelly

Hanna

Sperry

et al. 2019

The Journal of Hand Surgery

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“…The included publications were highly heterogenous in terms of how the possible association of ATTR amyloidosis with MSK manifestations was demonstrated (Tables 2 , 3 , 4 , 5 , 6 and 7 ). Biopsy followed by tissue staining of MSK or other specified tissues [ 14 , 16 , 18 , 21 , 22 , 25 , 27 , 30 , 33 – 37 , 44 , 51 , 61 , 63 , 66 , 68 , 74 , 75 , 81 , 91 , 92 , 94 – 96 , 99 , 101 , 102 , 104 , 106 – 115 , 117 – 119 , 121 , 124 – 131 , 134 , 139 , 148 – 150 , 152 – 160 , 171 , 173 , 175 , 177 , 183 ] were common. However, detecting amyloid in MSK tissues alone does not necessarily mean a patient is or will be diagnosed with ATTR amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal manifestations associated with transthyretin-mediated (ATTR) amyloidosis: a systematic review

Aldinc,

Campbell,

Gustafsson

et al. 2023

BMC Musculoskelet Disord

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Background Hereditary and wild-type transthyretin-mediated (ATTRv and ATTRwt) amyloidoses result from the misfolding of transthyretin and aggregation of amyloid plaques in multiple organ systems. Diagnosis of ATTR amyloidosis is often delayed due to its heterogenous and non-specific presentation. This review investigates the association of musculoskeletal (MSK) manifestations with ATTR amyloidosis and the delay from the onset of these manifestations to the diagnosis of ATTR amyloidosis. Methods This systematic review utilized Medline and EMBASE databases. Search criteria were outlined using a pre-specified patient, intervention, comparator, outcome, time, study (PICOTS) criteria and included: amyloidosis, ATTR, and MSK manifestations. Publication quality was assessed utilizing Joanna Briggs Institute (JBI) critical appraisal checklists. The search initially identified 7,139 publications, 164 of which were included. PICOTS criteria led to the inclusion of epidemiology, clinical burden and practice, pathophysiology, and temporality of MSK manifestations associated with ATTR amyloidosis. 163 publications reported on ATTR amyloidosis and MSK manifestations, and 13 publications reported on the delay in ATTR amyloidosis diagnosis following the onset of MSK manifestations. Results The MSK manifestation most frequently associated with ATTR amyloidosis was carpal tunnel syndrome (CTS); spinal stenosis (SS) and osteoarthritis (OA), among others, were also identified. The exact prevalence of different MSK manifestations in patients with ATTR amyloidosis remains unclear, as a broad range of prevalence estimates were reported. Moreover, the reported prevalence of MSK manifestations showed no clear trend or distinction in association between ATTRv and ATTRwt amyloidosis. MSK manifestations precede the diagnosis of ATTR amyloidosis by years, and there was substantial variation in the reported delay to ATTR amyloidosis diagnosis. Reports do suggest a longer diagnostic delay in patients with ATTRv amyloidosis, with 2 to 12 years delay in ATTRv versus 1.3 to 1.9 years delay in ATTRwt amyloidosis. Conclusion These findings suggest that orthopedic surgeons may play a role in the early diagnosis of and treatment referrals for ATTR amyloidosis. Detection of MSK manifestations may enable earlier diagnosis and administration of effective treatments before disease progression occurs.

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CTS Associated or Caused by Other Medical Conditions

Ward

2017

Carpal Tunnel Syndrome and Related Median Neuropathies

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Effect of synovial transthyretin amyloid deposition on preoperative symptoms and postoperative recovery of median nerve function among patients with idiopathic carpal tunnel syndrome

Cited by 10 publications

References 30 publications

Carpal Tunnel Syndrome: A Potential Early, Red-Flag Sign of Amyloidosis

Carpal Tunnel Syndrome: A Potential Early, Red-Flag Sign of Amyloidosis

Musculoskeletal manifestations associated with transthyretin-mediated (ATTR) amyloidosis: a systematic review

CTS Associated or Caused by Other Medical Conditions

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