Several distinct rheumatologic conditions are observed in A\u00df2M amyloidosis including: carpal tunnel syndrome, persistent joint effusions, spondyloarthropathy, and cystic bone lesions.\u00a0 Carpal tunnel syndrome is usually the first symptom of disease.\u00a0 Persistent joint effusions accompanied by mild discomfort occur in up to 50 % of patients on dialysis for more than 12 years.<\/p>\n
Involvement is bilateral and large joints (shoulders, knees, wrists, and hips) are more frequently affected.\u00a0 The synovial fluid is non-inflammatory and \u00df2-microglobulin amyloid deposits can be found if the sediment is examined with Congo red staining.\u00a0 Spondyloarthropathy with destructive changes of the intervertebral discs and paravertebral erosions have occurred in association with \u00df2-microglobulin amyloid deposits.\u00a0 Cystic bone lesions sometimes leading to pathologic fractures have been described in the femoral head, acetabulum, humerus, tibial plateau, vertebral bodies, and carpal bones.\u00a0 Although less common, visceral \u00df2-microglobulin amyloid deposits do occasionally occur in the gastrointestinal tract, heart, tendons and subcutaneous tissues of the buttocks.<\/p>\n
The treatment for A\u00df2M amyloidosis is difficult because the 11kD \u00df2-microglobulin molecule is too large to pass through a dialysis membrane.\u00a0 However, consistent with a postulated role of copper in initiating A\u00df2M fibrillogenesis, copper-free dialysis membranes appear to reduce the incidence of disease. Furthermore, patients on chronic ambulatory peritoneal dialysis usually have lower plasma levels of \u00df2-microglobulin than those on hemodialysis and may not develop amyloid deposits as quickly.\u00a0 Symptoms of arthropathy are common and prevalence may approach 100 percent of individuals on dialysis for more than 15 years.\u00a0 Patients who have received kidney transplants after developing A\u00df2M report an improvement in symptoms.<\/p>\n","protected":false},"excerpt":{"rendered":"
Several distinct rheumatologic conditions are observed in A\u00df2M amyloidosis including: carpal tunnel syndrome, persistent joint effusions, spondyloarthropathy, and cystic bone lesions.\u00a0 Carpal tunnel syndrome is usually the first symptom of disease.\u00a0 Persistent joint effusions accompanied by mild discomfort occur in up to 50 % of patients on dialysis for more than 12 years. Involvement is […]<\/p>\n","protected":false},"author":1079,"featured_media":0,"parent":1213,"menu_order":3,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/pages\/35"}],"collection":[{"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/users\/1079"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/comments?post=35"}],"version-history":[{"count":2,"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/pages\/35\/revisions"}],"predecessor-version":[{"id":2178,"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/pages\/35\/revisions\/2178"}],"up":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/pages\/1213"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/amyloid\/wp-json\/wp\/v2\/media?parent=35"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}