Amyloid deposition in systemic organs in long-term hemodialysis patients

Abstract

It has not been yet elucidated whether, in long-term hemodialysis patients, amyloid deposition in the transverse carpal ligament (TCL) is a symptom of systemic amyloidosis or a localized one. In 2 patients amyloid deposition was noted in the TCL which had been resected at operation, and we observed amyloid deposits also in other organs at autopsy after their deaths. In the two patients, no diseases resulting in secondary amyloidosis were observed. The unlabeled antibody peroxidase-antiperoxidase method (PAP method) served to reveal the deposits of beta 2-microglobulin (beta 2M) in the TCL and other organs comparable to the Congo red positive area. And the Congo red staining for the amyloid protein after potassium permanganate treatment was preserved. According to these results, the carpal tunnel syndrome (CTS) in long-term hemodialysis was considered as a symptom of systemic amyloidosis. Amyloid was deposited mainly in the vessel walls and the deposition was not circumferential but segmental.