Espes Daniel, Westermark Per
Uppsala Universitet - Institutionen för medicinsk cellbiologi Uppsala, Sweden Uppsala Universitet - Institutionen för medicinsk cellbiologi Uppsala, Sweden.
Uppsala Universitet - Insitutionen for immunologi, genetik och patologi Uppsala, Sweden Uppsala Universitet - Insitutionen for immunologi, genetik och patologi Uppsala, Sweden.
Lakartidningen. 2020 Feb 13;117:FSUF.
Biopsies from six diabetic patients with subcutaneous amyloid deposits formed by injected insulin have been sent to our laboratory during the last year. In all but one of the six patients a subcutaneous adipose tissue biopsy was taken due to suspicion of systemic amyloidosis. Four of these patients had renal insufficiency, with monoclonal gammopathy of undetermined significance (MGUS) in three while the fifth had heredity for transthyretin amyloidosis. In the sixth patient a biopsy was taken due to subcutaneous nodules at insulin injection sites. In all biopsies, large amounts of amyloid were present and their biochemical nature was elucidated by immunohistochemistry or western blot. The risk of incorrect interpretation with misdiagnosis of systemic amyloidosis is underlined. The consequences this may have on insulin treatment are insufficiently studied.
去年，六名患有由注射胰岛素形成的皮下淀粉样沉积物的糖尿病患者的活检样本被送到了我们实验室。除一名患者外，其余五名患者因怀疑患有系统性淀粉样变性而进行了皮下脂肪组织活检。其中四名患者有肾功能不全，三名患者有意义未明的单克隆丙种球蛋白病（MGUS），第五名患者有转甲状腺素蛋白淀粉样变性的遗传病史。第六名患者因胰岛素注射部位出现皮下结节而接受了活检。在所有活检样本中均发现了大量淀粉样物质，并通过免疫组织化学或蛋白质印迹法阐明了其生化性质。强调了对系统性淀粉样变性误诊的错误解读风险。这可能对胰岛素治疗产生的后果尚未得到充分研究。
