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Diagnosis of amyloidosis

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Amyloidosis should be suspected in nephropathy, persistent severe heart failure, malabsorption syndrome, or polyneuropathy of unclear etiology. In nephrotic syndrome or chronic renal failure, in addition to glomerulonephritis, it is necessary to exclude amyloidosis. The probability of amyloidosis increases with hepato- and splenomegaly.

Laboratory diagnosis of amyloidosis

In the clinical analysis of blood - anemia, leukocytosis, increased ESR; in the biochemical analysis of blood in almost 80% of cases at the onset of the disease, hypoproteinemia is detected (mainly the fraction of albumins is decreased), hyperglobulinemia, hyponatremia, hypoprothrombinemia, hypocalcemia. When liver damage can occur, hypercholesterolemia, in some cases - hyperbilirubinemia, increased activity of alkaline phosphatase.
In assessing the function of the thyroid gland, hypothyroidism can be detected.
In assessing kidney function, there are manifestations of renal failure. In the study of urine, in addition to protein, in the sediment, cylinders, erythrocytes, leukocytes are found.
At a coprological research the expressed steatorrhea, amylorrhea, kreatorrhea are observed.

A reliable method of diagnosing amyloidosis is a kidney biopsy. Quite often amyloid is found even with a biopsy of the rectum, liver, gums. With isolated heart disease, a diagnosis can be made with endomyocardial biopsy.

Differential diagnosis of amyloidosis

Amyloidosis is differentiated with a large group of diseases.

With lesions GASTROINTESTINAL TRACT - with a chronic gastritis, a peptic ulcer of a stomach and a duodenum.
With peripheral polyneuropathy - with diabetes mellitus, alcoholism, a deficiency of certain vitamins.
In the syndrome of the metacarpal canal - with hypothyroidism, traumatic injury.
With restrictive cardiomyopathy - with acute myocarditis of viral etiology, endomyocardial fibrosis, sarcoidosis, hemochromatosis.
With nephrotic syndrome - with glomerulonephritis, thrombosis of renal veins.
In chronic renal failure - with glomerulonephritis, obstruction of the urinary tract, toxic effects on the kidneys, acute tubular necrosis.
With symmetric polyarthritis - with rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus.
With interstitial lung lesions - with fibrosing alveolitis, sarcoidosis, pneumoconiosis.
With dementia - with Alzheimer's disease, dementia with multiple cerebral infarcts.

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