Amyloidosis

Last updated: Wednesday, 27, October, 2010
CausesAppropriate Tests

The classification of amyloidosis is complicated. There is some overlap in the list below:

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 ; free light chains 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

Serum free light chains

  • Primary amyloidosis
See also Paraproteinaemia
  • Multiple myeloma

Amyloid A origin

  • Chronic infection
  • Familial Mediterranean fever

Molecular genetic testing

ß2-microglobulin origin

Beta-2-microglobulin - serum.

  • Dialysis-associated

Familial + Inherited

  • Familial Mediterranean fever
  • Other

Localised deposition

  • Cerebral ("senile cerebral")
    • Alzheimer's disease

See under Dementia.

  • Laryngeal
  • Bladder
  • Tumour associated
    • Medullary carcinoma of thyroid

See under Thyroid nodule/cyst.

  • Cardiac ("senile cardiac")
  • Inflammatory