Gibson Ella, Ebong Imo A, Darrow Morgan A, Xiong Ge, Lipira Angelo B, Sood Ravi F
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California Davis, Sacramento, CA.
Division of Cardiology, Department of Internal Medicine, University of California Davis, Sacramento, CA.
J Hand Surg Glob Online. 2024 Aug 29;6(6):920-923. doi: 10.1016/j.jhsg.2024.07.013. eCollection 2024 Nov.
Patients undergoing trigger release surgery are known to be at increased risk of amyloidosis and heart failure, and therefore, amyloidosis screening during trigger release surgery may facilitate early diagnosis and treatment of cardiac amyloidosis. However, the reported prevalence of amyloid on biopsies taken during trigger release surgery has varied widely, and no biopsy-positive patients in prior studies have been diagnosed with occult cardiac amyloidosis or started on disease-modifying therapy. We review the existing literature on this topic and present a case of a patient with cardiac amyloidosis diagnosed from a biopsy taken during trigger release surgery and subsequently started on disease-modifying therapy. This case supports the potential role of amyloidosis screening during trigger release and highlights the benefits of collaboration between hand surgeons and amyloidosis specialists in multidisciplinary amyloidosis programs.
已知接受扳机指松解手术的患者发生淀粉样变性和心力衰竭的风险增加,因此,在扳机指松解手术期间进行淀粉样变性筛查可能有助于心脏淀粉样变性的早期诊断和治疗。然而,据报道,扳机指松解手术期间所取活检组织中淀粉样蛋白的患病率差异很大,并且既往研究中没有活检呈阳性的患者被诊断为隐匿性心脏淀粉样变性或开始接受疾病修饰治疗。我们回顾了关于这一主题的现有文献,并介绍了一例通过扳机指松解手术期间所取活检确诊为心脏淀粉样变性并随后开始接受疾病修饰治疗的患者。该病例支持了扳机指松解期间进行淀粉样变性筛查的潜在作用,并强调了手外科医生与淀粉样变性专家在多学科淀粉样变性项目中合作的益处。