Amyloidosis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[3]

Overview

Laboratory findings in amyloidosis include elevated erythrocyte sedimentation rate, increased BUN level, serum creatinine, protein, casts, or fat bodies in urine. Serum troponin, B-type natriuretic peptide, and beta-2-microglobulin are prognostic markers for heart failure. Amyloid deposits can be identified histologically by Congo red staining and viewing under polarized light where amyloid deposits produce a distinctive 'apple green birefringence'. Alternatively, thioflavin T stain may be used. An abdominal fat pad aspiration, rectal mucosa biopsy, or bone marrow biopsy can help confirm the diagnosis. They reveal positive findings in 80% patients.

Laboratory Findings

Cardiac

  • Cardiac biomarkers are the most important predictors of outcome in amyloidosis.
  • They provide a quantitative assessment for cardiac damage and wall strain.[1]
  • The biomarkers include:
  • Troponin I or Troponin T
  • BNP and NT-proBNP

Hepatic

  • AST
  • ALT
  • Total bilirubin
  • Alkaline phosphatase
  • Albumin

Renal

  • A variety of kidney function tests can suggest amyloidosis.
  • These tests include abnormalities in:

Thyroid

  • Common tests that are abnormal in thyroidal involvement of amyloidosis include:
  • TSH
  • Free T4

Bone marrow

References

  1. Merlini G, Seldin DC, Gertz MA (May 2011). "Amyloidosis: pathogenesis and new therapeutic options". J. Clin. Oncol. 29 (14): 1924–33. doi:10.1200/JCO.2010.32.2271. PMC 3138545. PMID 21483018.
  2. Kourelis TV, Kumar SK, Gertz MA, Lacy MQ, Buadi FK, Hayman SR; et al. (2013). "Coexistent multiple myeloma or increased bone marrow plasma cells define equally high-risk populations in patients with immunoglobulin light chain amyloidosis". J Clin Oncol. 31 (34): 4319–24. doi:10.1200/JCO.2013.50.8499. PMC 4881366. PMID 24145344.




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