Amyloidosis laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D.  Shyam Patel ; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.
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.
- Cardiac biomarkers are the most important predictors of outcome in amyloidosis.
- They provide a quantitative assessment for cardiac damage and wall strain.
- The biomarkers include:
- Troponin I or Troponin T
- BNP and NT-proBNP
- Liver function tests, including:
- Total bilirubin
- Alkaline phosphatase
- A variety of kidney function tests can suggest amyloidosis.
- These tests include abnormalities in:
- Serum creatinine
- Urinary protein
- Glomerular filtration rate
- Albumin to creatinine ratio in the urine
- Common tests that are abnormal in thyroidal involvement of amyloidosis include:
- Free T4
- Concurrent multiple myeloma can be found in patients with amyloidosis.
- In such cases, laboratory testing should include:
- Serum protein electrophoresis
- Immunoglobulin levels
- Serum free light chains
- ↑ 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.
- ↑ 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.