Document Detail


Beta-2-microglobulin-associated amyloidosis in chronic hemodialysis patients with carpal tunnel syndrome.
MedLine Citation:
PMID:  2646507     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical manifestations of beta-2-microglobulin (beta 2M)-associated amyloidosis in chronic hemodialysis patients with carpal tunnel syndrome from a medical center hospital are presented. The predominant morbidity of beta 2M-amyloid was musculoskeletal, with deposits identified in surgical or biopsy specimens from trigger fingers, carpal tunnels, fractures, and radiolucent bone lesions. Lucent bone lesions were the characteristic radiologic finding of beta 2M-amyloidosis and were most commonly found in carpal bones, humeral heads, and femoral heads. Carpal tunnel syndrome occurred in greater than 20% of our chronic hemodialysis patients. The longer the period of time on chronic hemodialysis the greater the morbidity from beta 2M-amyloid. Although significant amounts of beta 2M-amyloid were detected in the perivascular regions of viscera, clinical compromise of internal organs from this type of amyloid was not documented. In acute studies, beta 2M clearance during hemodialysis was markedly increased using the Fresenius polysulfone dialyzers compared to cuprophane dialyzers. In summary, beta 2M-amyloid is common and causes significant morbidity in chronic hemodialysis patients. Long-term dialysis with highly permeable membranes effects greater beta 2M clearance which may result in less tissue deposition of beta 2M-amyloid, and therefore, fewer clinical complications.
Authors:
M E Ullian; W S Hammond; A C Alfrey; A Schultz; B A Molitoris
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Medicine     Volume:  68     ISSN:  0025-7974     ISO Abbreviation:  Medicine (Baltimore)     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-04-14     Completed Date:  1989-04-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985248R     Medline TA:  Medicine (Baltimore)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  107-15     Citation Subset:  AIM; IM    
Affiliation:
Division of Nephrology, Veterans Administration Medical Center, Denver, Colorado 80220.
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MeSH Terms
Descriptor/Qualifier:
Amyloid / analysis*
Amyloidosis / etiology*,  metabolism
Bone Diseases / etiology
Carpal Tunnel Syndrome / etiology*,  metabolism
Humans
Male
Middle Aged
Muscular Diseases / etiology
Renal Dialysis / adverse effects*
Synovial Membrane / analysis
beta 2-Microglobulin / analysis*
Chemical
Reg. No./Substance:
0/Amyloid; 0/beta 2-Microglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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