Navarro-Saez María Del Carmen, Feijoo-Massó Carlos, Berenguer Sánchez Alex, Parra Parente Tamara, Guillamon Toran Laura, Marcano-Fernández Francesc, Camara-Cabrera Jaume, Bravo Ferrer Zully Del Carmen, Comet Monte Ricard, Calvet Calvo Xavier
Acute Geriatric Unit and Infectious Diseases Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain.
Internal Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain.
J Clin Med. 2024 Jul 24;13(15):4328. doi: 10.3390/jcm13154328.
: To determine the prevalence of amyloidosis through the analysis of synovial tissue and transverse carpal ligament (TCL) in patients undergoing surgery for carpal tunnel syndrome (CTS), detect predictive factors for the presence of amyloid, and assess cardiac involvement degree. : A prospective study with longitudinal cohort follow-up at a teaching hospital. Patients undergoing CTS surgery from 1 January 2019 to 31 May 2021 were included. Samples from synovial and TCL tissues were examined for amyloid presence. Multivariate analysis was used to detect predictive factors of the presence of amyloid. Patients with amyloid underwent echocardiography, laboratory analyses, and scintigraphy. : Two hundred and forty-six patients were included. The prevalence of amyloid was 11.4% in TCL and 12.6% in synovial tissues. Age ( = 0.035; OR 1.123), bilateral CTS symptoms ( = 0.022; OR 3.647), and trigger finger ( < 0.001; OR 3.537) were predictors of the presence of amyloid. Seventeen patients were diagnosed with transthyretin amyloidosis (ATTR) located in the carpus (no scintigraphic cardiac uptake or grade 0), one with light chain amyloidosis, eight with ATTR with cardiac involvement (grades 2-3), and five with ATTR in the carpus and scintigraphic uptake grade 1 (with normal echocardiogram and blood and urine tests). : We detected amyloid in 12.6% of unselected consecutive patients who underwent CTS surgery. Biopsy in patients with CTS for amyloid detection, especially in elderly patients with bilateral symptoms and trigger finger, may be useful for the early diagnosis of amyloidosis, primarily due to transthyretin.
通过分析腕管综合征（CTS）手术患者的滑膜组织和腕横韧带（TCL）来确定淀粉样变性的患病率，检测淀粉样蛋白存在的预测因素，并评估心脏受累程度。：在一家教学医院进行的前瞻性纵向队列随访研究。纳入2019年1月1日至2021年5月31日接受CTS手术的患者。检查滑膜和TCL组织样本中是否存在淀粉样蛋白。采用多变量分析检测淀粉样蛋白存在的预测因素。淀粉样蛋白患者接受超声心动图、实验室分析和闪烁扫描。：纳入246例患者。TCL中淀粉样变性的患病率为11.4%，滑膜组织中为12.6%。年龄（P = 0.035；OR 1.123）、双侧CTS症状（P = 0.022；OR 3.647）和扳机指（P < 0.001；OR 3.537）是淀粉样蛋白存在的预测因素。17例患者被诊断为位于腕部的转甲状腺素蛋白淀粉样变性（ATTR）（无闪烁扫描心脏摄取或0级），1例为轻链淀粉样变性，8例为有心脏受累的ATTR（2 - 3级），5例为腕部ATTR且闪烁扫描摄取为1级（超声心动图、血液和尿液检查正常）。：我们在未选择的连续接受CTS手术的患者中检测到12.6%存在淀粉样蛋白。对CTS患者进行活检以检测淀粉样蛋白，特别是对有双侧症状和扳机指的老年患者，可能有助于淀粉样变性的早期诊断，主要是由于转甲状腺素蛋白。
