When assessing patients for suspected systemic amyloidosis, biopsy of the abdominal fat pad has the highest sensitivity at 90%, followed by biopsy of the rectal mucosa, which has a sensitivity of 73%-84%. For patients whose biopsy results from either of these sites are negative and in whom systemic amyloidosis is still suspected, biopsy of affected organs may be considered. Specific organ biopsy offers the benefit of drawing a clear line of cause and effect between amyloid deposition and organ dysfunction.
Congo red histologic staining and immunohistochemical staining of biopsy specimens are required to diagnose and classify amyloidosis. Different fibril types may require different treatment approaches, so samples are tested with commercially available antibodies specific to major amyloid fibril precursors.
For more on diagnostic approaches for amyloidosis, read here.
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Cite this: Herbert S. Diamond. Fast Five Quiz: How Much Do You Know About Amyloidosis? - Medscape - Nov 02, 2018.