Regresar

AL-amyloidosis is underdiagnosed in renal biopsies

Abstract:

Background. Renal amyloidosis is associated with a variety of underlying disease processes. Although amyloid is identical in appearance in these diseases, the precursor proteins are different. Immunofluorescence microscopy has been used as the primary tool in the diagnostic evaluation of the underlying cause of renal AL-amyloidosis. The purpose of this study was to document the sensitivity of immunofluorescence microscopy in AL-amyloidosis. Methods. We reviewed 36 renal biopsies from patients with amyloidosis collected in two medical centres. All biopsies showed characteristic fibrillary deposits of amyloid on electron microscopy and stained positive with Congo red or Thioflavin-T. Results. Among these 36 patients, immunofluorescence staining for λ and κ light chains was negative or equivocal in 14 biopsies. Of these 14 patients, two patients had evidence of AA …