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==Overview==
==Overview==
Laboratory findings depend on the organs involved. Laboratory testing of specific organs can reveal dysfunction, and the degree of laboratory derangement is usually related to the extent of amyloid involvement.
[[Laboratory]] findings depend on the [[Organ (anatomy)|organs]] involved. [[Laboratory]] testing of specific [[Organ (anatomy)|organs]] can reveal dysfunction, and the degree of [[laboratory]] derangement is usually related to the extent of [[amyloid]] involvement.


==Laboratory Findings==
==Laboratory Findings==
*'''Cardiac''': Cardiac biomarkers are the most important predictors of outcome in amyloidosis and provide a quantitative assessment for cardiac damage and wall strain:<ref name="pmid21483018">{{cite journal |vauthors=Merlini G, Seldin DC, Gertz MA |title=Amyloidosis: pathogenesis and new therapeutic options |journal=J. Clin. Oncol. |volume=29 |issue=14 |pages=1924–33 |date=May 2011 |pmid=21483018 |pmc=3138545 |doi=10.1200/JCO.2010.32.2271 |url=}}</ref>
 
=== '''Cardiac''' ===
 
* [[Cardiac biomarkers]] are the most important predictors of outcome in amyloidosis.
* They provide a quantitative assessment for [[Heart|cardiac]] damage and wall strain.<ref name="pmid21483018">{{cite journal |vauthors=Merlini G, Seldin DC, Gertz MA |title=Amyloidosis: pathogenesis and new therapeutic options |journal=J. Clin. Oncol. |volume=29 |issue=14 |pages=1924–33 |date=May 2011 |pmid=21483018 |pmc=3138545 |doi=10.1200/JCO.2010.32.2271 |url=}}</ref>
* The biomarkers include:
 
** Troponin I or Troponin T
** Troponin I or Troponin T
** BNP and NT-proBNP
** BNP and NT-proBNP
*'''Hepatic''': Liver functions tests include:
 
=== '''Hepatic''' ===
 
* [[Liver function tests]], including:
 
**AST
**AST
**ALT
**ALT
Line 16: Line 26:
**Alkaline phosphatase
**Alkaline phosphatase
**Albumin
**Albumin
*'''Renal''': A variety of kidney function tests can suggest amyloidosis. These include abnormalities in:
 
**Serum creatinine
=== '''Renal''' ===
**Urinary protein
 
**Glomerular filtration rate
* A variety of kidney function tests can suggest amyloidosis.  
**Albumin to creatinine ratio in the urine
* These [[Test|tests]] include abnormalities in:
*'''Thyroid''': Common tests that are abnormal in thyroidal involvement of amyloidosis include:
 
**[[Creatinine|Serum creatinine]]
**[[Urinary]] [[protein]]
**[[Glomerular filtration rate]]
**[[Albumin]] to [[creatinine]] ratio in the [[urine]]
 
=== '''Thyroid''' ===
 
* Common [[Test|tests]] that are abnormal in thyroidal involvement of amyloidosis include:
 
**TSH
**TSH
**Free T4
**Free T4
*'''Bone marrow''': Concurrent multiple myeloma can be found in patients with amyloidosis. In such cases, laboratory testing should include<ref name="pmid24145344">{{cite journal| author=Kourelis TV, Kumar SK, Gertz MA, Lacy MQ, Buadi FK, Hayman SR et al.| title=Coexistent multiple myeloma or increased bone marrow plasma cells define equally high-risk populations in patients with immunoglobulin light chain amyloidosis. | journal=J Clin Oncol | year= 2013 | volume= 31 | issue= 34 | pages= 4319-24 | pmid=24145344 | doi=10.1200/JCO.2013.50.8499 | pmc=4881366 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24145344  }} </ref>:
 
**Serum protein electrophoresis
=== '''Bone marrow''' ===
**Immunoglobulin levels
 
**Serum free light chains
* Concurrent [[multiple myeloma]] can be found in [[Patient|patients]] with amyloidosis.  
**Beta-2-microglobulin
* In such cases, [[laboratory]] [[Test|testing]] should include<ref name="pmid24145344">{{cite journal| author=Kourelis TV, Kumar SK, Gertz MA, Lacy MQ, Buadi FK, Hayman SR et al.| title=Coexistent multiple myeloma or increased bone marrow plasma cells define equally high-risk populations in patients with immunoglobulin light chain amyloidosis. | journal=J Clin Oncol | year= 2013 | volume= 31 | issue= 34 | pages= 4319-24 | pmid=24145344 | doi=10.1200/JCO.2013.50.8499 | pmc=4881366 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24145344  }} </ref>:
 
**[[Serum protein electrophoresis]]
**[[Immunoglobulin]] levels
**[[Serum]] free light chains
**[[Beta-2 microglobulin|Beta-2-microglobulin]]


== References ==
== References ==

Revision as of 01:07, 26 October 2019

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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 depend on the organs involved. Laboratory testing of specific organs can reveal dysfunction, and the degree of laboratory derangement is usually related to the extent of amyloid involvement.

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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