Skin Biopsy Gives the Potential Benefit in the Diagnosis of Systemic Amyloidosis Associated With Cardiac Involvement

Huang, Chunyu; Wang, Wen-Jen; Wong, Chu‐Kwan

doi:10.1001/archderm.134.5.643

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…Skin and rectal biopsies are also positive in more than 80% of patients, which is comparable to subcutaneous abdominal fat aspiration (Kyle and Greipp, 1983;Huang et al, 1998).…”

Section: Diagnostic Evaluationmentioning

confidence: 72%

Neurological complications in plasma cell dyscrasias

Bayat

Kelly

2012

Handbook of Clinical Neurology

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“…Skin and rectal biopsies are also positive in more than 80% of patients, which is comparable to subcutaneous abdominal fat aspiration (Kyle and Greipp, 1983;Huang et al, 1998).…”

Section: Diagnostic Evaluationmentioning

confidence: 72%

Neurological complications in plasma cell dyscrasias

Bayat

Kelly

2012

Handbook of Clinical Neurology

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“…In the absence of monoclonal gammopathy, technetium‐labeled cardiac scintigraphy can diagnose cardiac ATTR amyloidosis with a positive predictive value of 100%. Other modalities include skin biopsy 76 to evaluate for amyloid deposits and evidence of small fiber neuropathy (SFN), 77 feet electrochemical skin conductance 78 to measure early dysautonomia and periumbilical US for amyloid deposits. 79 …”

Section: Methodsmentioning

confidence: 99%

“…Mass spectrometry offers higher sensitivity and specificity but is expensive and primarily found in specialized centers. [70][71][72][73][74] 76 to evaluate for amyloid deposits and evidence of small fiber neuropathy (SFN), 77 feet electrochemical skin conductance 78 to measure early dysautonomia and periumbilical US for amyloid deposits. 79…”

Section: Amyloid Neuropathymentioning

confidence: 99%

Nerve biopsy: Current indications and decision tools

et al. 2021

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After initial investigation of patients presenting with symptoms suggestive of neuropathy, a clinical decision is made for a minority of patients to undergo further assessment with nerve biopsy. Many nerve biopsies do not demonstrate a definitive pathological diagnosis and there is considerable cost and morbidity associated with the procedure. This highlights the need for appropriate selection of patients, nerves and neuropathology techniques. Additionally, concomitant muscle and skin biopsies may improve the diagnostic yield in some cases. Several advances have been made in diagnostics in recent years, particularly in genomics. The indications for nerve biopsy have consequently changed over time. This review explores the current indications for nerve biopsies and some of the issues surrounding its use. Also included are comments on alternative diagnostic modalities that may help to supplant or reduce the use of nerve biopsy as a diagnostic test. These primarily include extraneural biopsy and neuroimaging techniques such as magnetic resonance neurography and nerve ultrasound. Finally, we propose an algorithm to assist in deciding when to perform nerve biopsies.

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“…), which have a high rate of positivity when clinically affected, but involve more risk. The relatively new technique of skin biopsies to diagnose small fiber neuropathy can reveal amyloid in blood vessels of subcutaneous tissues when properly stained [34].…”

Section: Diagnosismentioning

confidence: 99%

“…Unfortunately, many patients do not qualify for this new treatment. Dispenzieri and colleagues found that only 234 of 1,228 patients with amyloidosis satisfied eligibility criteria for transplantation [34]. Diagnosis is delayed most (median 26 months) in patients with relatively pure neuropathies without significant organ failure, who are the most likely to benefit from peripheral blood stem cell transplantation [1,48,49].…”

Section: Managementmentioning

confidence: 99%

Primary Systemic Amyloid Neuropathy

Bajwa

Kelly

2010

Amyloidosis

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Primary systemic amyloidosis (PSA) is a plasma cell dyscrasia. Organ damage is caused by deposition of amyloid, derived from monoclonal light chains, in tissues including nerves. PSA damages tissues and leads to combinations of neuropathy and renal, cardiac, and liver failure. The neuropathy of PSA is relatively stereotyped with damage to small and autonomic nerve fibers and superimposed carpal tunnel syndrome. The disease is progressive and mortality is high, especially when there is early involvement of vital organs. Treatment in the past was relatively ineffective. However, with the advent of peripheral blood stem cell transplantation and chemotherapy in selected patients, prolonged survival is possible if the weight of organ damage at onset of treatment is not too high. Thus, early detection is paramount.

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Skin Biopsy Gives the Potential Benefit in the Diagnosis of Systemic Amyloidosis Associated With Cardiac Involvement

Cited by 13 publications

References 6 publications

Neurological complications in plasma cell dyscrasias

Neurological complications in plasma cell dyscrasias

Nerve biopsy: Current indications and decision tools

Primary Systemic Amyloid Neuropathy

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