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<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=95 BGCOLOR="#999999" TEXT="#080000" bgproperties="fixed" background="048005f0ermwup.png"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>amyloidosis</B></FONT><B>     </B><B>|     </B><A HREF="index.htm" TARGET="_top" TITLE="amyloidosis"><U><B>home</B></U></A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="DEFINITION GENERALITY"><U>DEFINITION GENERALITY</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="specificity"><U>specificity</U></A>   |   <B>chart</B>   |   <A HREF="id22.htm" TARGET="_top" TITLE="pictures"><U>pictures</U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Treatment"><U>Treatment</U></A>   |   <A HREF="id17.htm" TARGET="_top" TITLE="Related Links"><U>Related Links</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Contact Me"><U>Contact Me</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B>Danil Hammoudi.MD</B></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="DEFINITION GENERALITY"><U><B>DEFINITION GENERALITY</B></U></A></div> <div> <A HREF="id20.htm" TARGET="_top" TITLE="specificity"><U><B>specificity</B></U></A></div> <div> <B>chart</B></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="pictures"><U><B>pictures</B></U></A></div> <div> <A HREF="id23.htm" TARGET="_top" TITLE="Treatment"><U><B>Treatment</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Related Links"><U><B>Related Links</B></U></A></div> <div> <A HREF="id18.htm" TARGET="_top" TITLE="Contact Me"><U><B>Contact Me</B></U></A></div> </td> <td valign="top" height=385 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> chart</div> <div> <IMG SRC="05dbddd0.png" border=0 width="445" height="221" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <bR> <bR> <bR> <div> <B>Classifications of Amyloidosis</B> </div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="454" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 57 ><NOBR><div> Clinical</div> <div> Classification</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="222"><div> Associated Condition</div> </tD> <tD VALIGN=CENTER WIDTH="45"><div> Amyloid Fibril</div> <div> Type</div> </tD> <tD VALIGN=CENTER><NOBR><div> Precursor</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=4 HEIGHT= 19 WIDTH="444"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="444" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 19 WIDTH="330"><div> <U>Systemic Amyloidosis</U></div> </tD> <tD VALIGN=CENTER WIDTH="45"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="45" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="67"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="67" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 57 WIDTH="107"><div> Primary or</div> <div> Secondary</div> </tD> <tD VALIGN=CENTER WIDTH="222"><div> Multiple myeloma</div> </tD> <tD VALIGN=CENTER WIDTH="45"><div> AL</div> </tD> <tD VALIGN=CENTER WIDTH="67"><div> Iglambda</div> <div> (or kappa chains)</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 75 WIDTH="107"><div> Secondary</div> </tD> <tD VALIGN=CENTER><NOBR><div> Chronic inflammatory disease</div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Rheumatoid arthritis</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Tuberculosis</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Skin and lung abscesses</FONT></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="45"><div> AA</div> </tD> <tD VALIGN=CENTER WIDTH="67"><div> SAA</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="107"><div> Secondary</div> </tD> <tD VALIGN=CENTER WIDTH="222"><div> Cancer</div> <div> Hodgkin's disease </div> </tD> <tD VALIGN=CENTER WIDTH="45"><div> AA</div> </tD> <tD VALIGN=CENTER WIDTH="67"><div> SAA</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="107"><div> Secondary</div> </tD> <tD VALIGN=CENTER><NOBR><div> Hemodialysis for CRF(*)</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="45"><div> beta2-m(**)</div> </tD> <tD VALIGN=CENTER><NOBR><div> beta2-m</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 94 WIDTH="107"><div> Primary</div> </tD> <tD VALIGN=CENTER><NOBR><div> Heredofamilial amyloidosis</div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Familial Mediterranean</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Fever</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Familial amyloid</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >polyneuropathy </FONT></div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> AA</div> <bR> <bR> <div> Transthyretin</div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> SAA</div> <bR> <bR> <div> Transthyretin(#)</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 19 WIDTH="330"><div> <U>Localized Amyloidosis</U></TD</div> </tD> <tD VALIGN=CENTER WIDTH="45"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="45" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="67"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="67" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="107"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="107" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="222"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="222" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="45"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="45" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="67"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="67" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="107"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="107" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER><NOBR><div> Senile cardiac amyloidosis</div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Transthyretin</div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Transthyretin</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 76 WIDTH="107"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="76" ALIGN="bottom" WIDTH="107" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER><NOBR><div> Senile cerebral amyloidosis:</div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Alzheimer's disease</FONT></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="45"><div> Amyloid beta protein</div> </tD> <tD VALIGN=CENTER WIDTH="67"><div> Amyloid precursor protein (APP)</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 56 WIDTH="107"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="56" ALIGN="bottom" WIDTH="107" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER><NOBR><div> Endocrine tumors</div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >Medullary carcinoma</FONT></div> <div> __<FONT SIZE="3" COLOR="#000000" FACE="Arial" >of thyroid</FONT></div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Procaltitonin</div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Calcitonin</div> </NOBR></tD> </tR> </TABLE></div> <bR> <bR> <div> <IMG SRC="05ec2a10.png" border=0 width="450" height="417" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <B>Classification            </B> <B>Associated features</B>                      <B>Protein component</B></div> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="638" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 56 WIDTH="220"><div> Secondary</div> </tD> <tD VALIGN=CENTER><NOBR><div> Rheumatoid arthritis</div> <div> Inflammatory disorders</div> <div> <U>Leprosy</U><FONT SIZE="3" COLOR="#000000" FACE="Arial" >: Chronic</FONT></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="206"><div> Protein A </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 56 ><NOBR><div> Familial Mediterranean fever </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="192"><div> Renal disease</div> <div> Abdominal pain</div> </tD> <tD VALIGN=CENTER><NOBR><div> Protein A</div> <div> 1<FONT SIZE="1" COLOR="#000000" FACE="Arial" >o</FONT> cause: Marenostrin</div> <div> Treatment: Colchicine </div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 56 WIDTH="220"><div> Familial Visceral </div> </tD> <tD VALIGN=CENTER WIDTH="192"><div> Renal disease</div> <div> Organomegaly</div> </tD> <tD VALIGN=CENTER WIDTH="206"><div> Fibrinogen, <FONT SIZE="3" COLOR="#000000" FACE="symbol" >a</FONT>-chain </div> <div> <U>Apolipoprotein A-1</U></div> <div> Lysozyme </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="220"><div> AF</div> </tD> <tD VALIGN=CENTER WIDTH="192"><div> Cardiopathic</div> </tD> <tD VALIGN=CENTER><NOBR><div> <U>Transthyretin</U><FONT SIZE="3" COLOR="#000000" FACE="Arial" > (mutation)</FONT></div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="220"><div> Senile Systemic</div> </tD> <tD VALIGN=CENTER WIDTH="192"><div> Cardiopathic</div> </tD> <tD VALIGN=CENTER><NOBR><div> Transthyretin (normal)</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 94 WIDTH="220"><div> Dialysis-associated</div> </tD> <tD VALIGN=CENTER><NOBR><div> Carpal tunnel syndrome</div> <div> Cysts: Bone; Tendon sheath</div> <div> Tendonitis: Hand; Shoulder</div> <div> Joint effusions& pain</div> <div> <U>Myelopathy</U></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="206"><div> b<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" >-microglobulin </FONT></div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="220"><div> Pancreatic amyloid</div> </tD> <tD VALIGN=CENTER><NOBR><div> Diabetes mellitus type 2</div> <div> Insulinomas</div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Islet amyloid polypeptide </div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 134 ><NOBR><div> Multiple endocrine neoplasia</div> <div> Type 2A </div> </NOBR></tD> <tD VALIGN=CENTER><NOBR><div> Thyroid carcinoma</div> <div> Medullary, with amyloid</div> <div> Pheochromocytoma</div> <div> Parathyroid adenomas</div> <div> Cutaneous </div> <div> Notalgia paresthetica:</div> <div> T<FONT SIZE="1" COLOR="#000000" FACE="Arial" >2</FONT>-T<FONT SIZE="1" COLOR="#000000" FACE="Arial" >6</FONT> posterior rami </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="206"><div> RET oncogene </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 56 ><NOBR><div> Lattice corneal dystrophy</div> <div> Type IIIA </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="192"><div> Corneal dystrophy</div> <div> & masses</div> <div> Cataracts </div> </tD> <tD VALIGN=CENTER><NOBR><div> b<FONT SIZE="3" COLOR="#000000" FACE="Arial" >-induced</FONT></div> <div> Transforming growth factor </div> </NOBR></tD> </tR> </TABLE></div> <bR> <bR> <bR> <bR> <bR> <bR> <div> <IMG SRC="065d09e0.png" border=0 width="464" height="158" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <B><U>AMYLOIDOSIS from dr.ED Freidlander [WWW.PATHGUY.COM]</U></B></div> <div> <TABLE BORDER="0" CELLPADDING="1" CELLSPACING="1" WIDTH="565" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="VOID" RULES="NONE" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> COMPOSITION OF AMYLOID </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> AMYLOID NAME </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> CLINICAL CORRELATIONS </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 96 WIDTH="185"><div> Serum amyloid associated protein (acute phase reactant) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid A (AA)</div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> chronic inflammation (leprosy, osteomyelitis, tuberculosis, rheumatoid arthritis, etc.); New Guinea amyloid goiter</div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 57 WIDTH="185"><div> Immunoglobulin light chains </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid B (AL) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> B-cell proliferations (plasma cell myeloma, benign hyperplasias) </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 114 WIDTH="185"><div> Transthyretin </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid C (AF) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Substituted: Familial syndromes (Amyloid ATTR) </div> <div> Non-substituted: Old hearts ("senile cardiac amyloidosis") </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Various endocrine proteins </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid E<FONT SIZE="1" COLOR="#000000" FACE="Arial" >sub</FONT> </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Stromas of endocrine tumors (various ones) </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 ><NOBR><div> Beta-two microglobulin </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid H </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Chronic hemodialysis patients </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 96 ><NOBR><div> Amyloid beta protein </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid beta / A4 </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Cores of Alzheimer senile plaques; cerebral blood vessels in Alzheimer's and some congophilic angiopathy patients </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 ><NOBR><div> Tau microtubule protein </div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="185"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="38" ALIGN="bottom" WIDTH="185" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="185"><div> tangles, plaques, and granules of Alzheimer's </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 57 WIDTH="185"><div> Amylin (islet amyloid-associated peptide) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="57" ALIGN="bottom" WIDTH="185" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="185"><div> stroma of insulinomas; islands of some type II diabetics </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="185"><div> Prolactin </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> (An amyloid E) </div> </tD> <tD VALIGN=CENTER><NOBR><div> Old folks' pituitaries </div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Atrial natriuretic peptide/factor </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> A-ANF </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Old folks' atria </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 19 WIDTH="185"><div> Keratin </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Amyloid D </div> </tD> <tD VALIGN=CENTER><NOBR><div> Some skin diseases </div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Gamma trace alkaline microprotein (cystatin C) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="38" ALIGN="bottom" WIDTH="185" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="185"><div> Hereditary congophilic angiopathy of Iceland </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Gelsolin </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> AGel</div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Familial Finnish (Am. J. Path. <U>126:</U> 1223, 1990) </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Prion Precursor Protein (PRPP) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> AScr </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Prion diseases </div> </tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 38 WIDTH="185"><div> Apolipoprotein A1 (Am. J. Path. <U>154</U>: 221, 1999) </div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> AApoA1</div> </tD> <tD VALIGN=CENTER WIDTH="185"><div> Familial Iowa amyloid; dog amyloid </div> </tD> </tR> </TABLE></div> <div> There are many, many other rare familial amyloidosis syndromes (Blood <U>90</U>:4799, 1997).</div> <bR> </td> </tr></table></body>