A 60-year-old female is suffering from renal failure and is on hemodialysis since last 8 years. She developed Carpal Tunnel syndrome. Which of the following types of amyloid will be associated with it?
Ans. a. Beta-2 microglobulin (Ref: Harrison 19/e p719, 18/e p945-949: Robbins 9/e p256-262, 8/e pe p254)Patients on long-term hemodialysis for renal failure develop amyloidosis as a result of deposition of beta-microglobulin deposition.AmyloidosisAmyloidosis is a pathological proteinaceous substance deposited between cellsQ in various tissues and organs of the body in a variety of clinical settings.Types of Amyloid proteinAL (Amyloid Light chain):This is derived from plasma cellsQ and contains immunoglobulin light chainsAssociated with primary amyloidosis and immunocyte dyscrasias with amyloidosis like multiple myelomaQAA (Amyloid Associate protein):It is unique non-immunoglobulin protein synthesized by reticuloendothelial cells of liverQ.Associated with secondary amyloidosis and reactive systemic amyloidosisQ.Chronic inflammatory conditions: TuberculosisQ, BronchiectasisQ, OsteomyelitisQConnective tissue disorders: Rheumatoid Arthritis (MC)Q, Ankylosing spondylitisQ, and Primary biliary cirrhosisQNonimmune derived tumors: Renal cell carcinomaQ and Hodgkin's lymphomaQB2 Microalbumin (A b2m): Hemodialysis associated amyloidosisQB2 Amyloid protein: Senile cerebralQ, Alzheimer's diseaseQTransthyretin (ATTR) Familial amyloidotic neuropathiesQ and Systemic senile amyloidosisQCalcitonin associated amyloid (A cal (Ref: Medullary CA thyroidQIslet amyloid peptide (AIAPP) Type II DMQAtrial natriuretic factor associated amyloid: Isolated atrial Amyloidosis and Misfolded prion protein (PrPsc) diseaseCommon Biopsy sites in Amyloidosis: Subcutaneous abdominal fat aspirateQ, RectumQ, SkinQ, GingivaQ
Beta-2 microglobulin
Amyloid light chain
ATTR
Serum amyloid associated protein
Histo Pathology