Association between spinal stenosis and wild-type ATTR amyloidosis.

Autor: Godara A; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA.; Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA., Riesenburger RI; Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA., Zhang DX; Department of Medicine, Tufts Medical Center, Boston, MA, USA., Varga C; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA., Fogaren T; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA., Siddiqui NS; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA.; Division of Hematology, Medical Oncology and Palliative Care, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA., Yu A; School of Medicine, Tufts University, Boston, MA, USA., Wang A; School of Medicine, Tufts University, Boston, MA, USA., Mastroianni M; School of Medicine, Tufts University, Boston, MA, USA., Dowd R; Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA., Nail TJ; Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA., McPhail ED; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Kurtin PJ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Theis JD; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Toskic D; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA., Arkun K; Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA., Pilichowska M; Department of Pathology and Laboratory Medicine, Tufts Medical Center, Boston, MA, USA., Kryzanski J; Department of Neurosurgery, Tufts Medical Center, Boston, MA, USA., Patel AR; Division of Cardiology, Tufts Medical Center, Boston, MA, USA., Comenzo R; John Conant Davis Myeloma and Amyloid Program, Tufts Medical Center, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Amyloid : the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis [Amyloid] 2021 Dec; Vol. 28 (4), pp. 226-233. Date of Electronic Publication: 2021 Jul 15.
DOI: 10.1080/13506129.2021.1950681
Abstrakt: Age-related cardiac amyloidosis results from deposits of wild-type tranthyretin amyloid (ATTRwt) in cardiac tissue. ATTR may play a role in carpal tunnel syndrome (CTS) and in spinal stenosis (SS), indicating or presaging systemic amyloidosis. We investigated consecutive patients undergoing surgery for SS for ATTR deposition in the resected ligamentum flavum (LF) and concomitant risk of cardiac amyloidosis. Each surgical specimen (LF) was stained with Congo red, and if positive, the amyloid deposits were typed by mass spectrometry. Patients with positive specimens underwent standard of care evaluation with fat pad aspirates, serum and urine protein electrophoresis with immunofixation, free light-chain assay, TTR gene sequencing and technetium 99 m-pyrophosphate-scintigraphy. In 2018-2019, 324 patients underwent surgery for SS and 43 patients (13%) had ATTR in the LF with wild-type TTR gene sequences. Two cases of ATTRwt cardiac amyloidosis were diagnosed and received treatment. In this large series, ATTRwt was identified in 13% of the patients undergoing laminectomy for SS. Patients with amyloid in the ligamentum flavum were older and had a higher prevalence of CTS, suggesting a systemic form of ATTR amyloidosis involving connective tissue. Further prospective study of patients with SS at risk for systemic amyloidosis is warranted.
Databáze: MEDLINE
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