Ogawa H, Saito A, Hirabayashi N, Hara K
Department of Internal Medicine, Sinseikai Dai-Ichi Hospital, Nagoya, Japan.
Clin Nephrol. 1987 Oct;28(4):199-204.
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.
长期血液透析患者腕横韧带（TCL）中的淀粉样沉积是全身性淀粉样变性的症状还是局限性的，目前尚未阐明。在2例患者中，手术切除的TCL中发现有淀粉样沉积，并且我们在其死后尸检时还在其他器官中观察到了淀粉样沉积物。在这两名患者中，未观察到导致继发性淀粉样变性的疾病。未标记抗体过氧化物酶-抗过氧化物酶法（PAP法）用于揭示TCL和其他器官中与刚果红阳性区域相当的β2-微球蛋白（β2M）沉积物。高锰酸钾处理后淀粉样蛋白的刚果红染色得以保留。根据这些结果，长期血液透析中的腕管综合征（CTS）被认为是全身性淀粉样变性的症状。淀粉样物质主要沉积在血管壁，且沉积不是周向的而是节段性的。
