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Transthyretin-derived amyloidosis: Probably a common cause of lumbar spinal stenosis.
Ups J Med Sci. 2014 Mar 12. [Epub ahead of print] doi:
Westermark P, Westermark GT, Suhr OB, Berg S
Abstract:
Senile systemic amyloidosis (SSA).....is, however, a systemic disease, and amyloid deposits may appear in many other tissues but are thought to be without clinical symptoms outside the heart. Amyloid is a very common finding in cartilage and ligaments of elderly subjects, and transthyretin has been demonstrated in some deposits. Lumbar spinal stenosis is also a condition of usually elderly individuals in whom narrowing of the lumbar spinal canal leads to compression of nerves to the lower limbs.....
We questioned whether lumbar spinal stenosis sometimes could be a manifestation of undiagnosed SSA. In this first report we have studied the presence of amyloid in material obtained at surgery for spinal stenosis in 26 patients. Amyloid was found in 25 subjects. Transthyretin was demonstrated immunohistochemically in 5 out of 15 studied resected tissues. Four of the positive materials were analyzed with Western blot revealing both full-length transthyretin (TTR) and C-terminal TTR fragments, typically seen in SSA
.....We conclude that lumbar spinal stenosis quite frequently may be a consequence of SSA and that further studies are warranted.
We questioned whether lumbar spinal stenosis sometimes could be a manifestation of undiagnosed SSA. In this first report we have studied the presence of amyloid in material obtained at surgery for spinal stenosis in 26 patients. Amyloid was found in 25 subjects. Transthyretin was demonstrated immunohistochemically in 5 out of 15 studied resected tissues. Four of the positive materials were analyzed with Western blot revealing both full-length transthyretin (TTR) and C-terminal TTR fragments, typically seen in SSA
.....We conclude that lumbar spinal stenosis quite frequently may be a consequence of SSA and that further studies are warranted.
PMID: 24620715
Tags: SSA, transthyretin