| Strong Transthyretin Immunostaining: Potential Pitfall in Cardiac Amyloid Typing. | |
| | |
MedLine Citation:
|
PMID: 21945954 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Although systemic amyloidosis commonly presents with renal disease, cardiac involvement usually determines the patient's prognosis. Cardiac involvement is seen in light chain amyloid and transthyretin amyloidosis. Distinguishing between these two is critical because prognosis and treatment differ. Our study demonstrates the unreliability of transthyretin immunostaining in subtyping cardiac amyloid. Between January 2003 and August 2010, we retrieved 229 native endomyocardial biopsies, of which 24 had amyloid. Immunohistochemistry for κ, λ, transthyretin, and serum amyloid A protein was performed on formalin-fixed, paraffin-embedded sections. Staining was graded as weak (trace to 1+) or strong (2 to 3+). Mass spectrometry (MS)-based proteomic typing of microdissected amyloid material was performed on selected cases. Fifteen patients had monoclonal gammopathy/plasma cell dyscrasia with cardiac amyloid. Eight of them (53%) showed strong transthyretin staining in the cardiac amyloid deposits. MS was performed in 5 of these 8 biopsies, and all 5 biopsies revealed light chain amyloid-type amyloid. Two of these 5 light chain amyloid biopsies did not even have concomitant strong staining for the appropriate light chain. Among the 15 cases with plasma cell dyscrasia, only 7 biopsies showed strong staining for the corresponding monoclonal light chain. Strong, false-positive immunostaining for transthyretin in cardiac amyloid is a potential pitfall, augmented by the frequent lack of staining for immunoglobulin light chains. Therefore, the presence of amyloid in the cardiac biopsy should prompt a search for plasma cell dyscrasia irrespective of transthyretin staining. Confirmation with MS should be sought, particularly if there is any discrepancy between κ/λ staining and serum immunofixation results. |
| | |
Authors:
|
Anjali A Satoskar; Yvonne Efebera; Ayesha Hasan; Sergey Brodsky; Gyongyi Nadasdy; Ahmet Dogan; Tibor Nadasdy |
Related Documents
:
|
9893824 - Abnormal motion displacement thresholds are associated with fine scale luminance sensit... 4578974 - The range of attractant concentrations for bacterial chemotaxis and the threshold and s... 1486204 - High-frequency thresholds: circumaural earphone versus insert earphone. 8594824 - Detection of first-order structure in optic flow fields. 2928064 - Effects of preshot routine on free-throw shooting. 20330554 - Relative salience of acoustic features in zebra finch song. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-9-22 |
Journal Detail:
|
Title: The American journal of surgical pathology Volume: - ISSN: 1532-0979 ISO Abbreviation: - Publication Date: 2011 Sep |
Date Detail:
|
Created Date: 2011-9-27 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7707904 Medline TA: Am J Surg Pathol Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
Departments of *Pathology †Hemato-Oncology ‡Cardiology, The Ohio State University, OH §Department of Pathology, Mayo Clinical Laboratories, MN. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Maintenance of Remission Among Patients with Crohn's Disease on Anti-Metabolite Therapy after Inflix...
Next Document: Somatic Mutations in PIK3CA and Activation of AKT in Intraductal Tubulopapillary Neoplasms of the Pa...