Accurate diagnosis of systemic amyloidosis is necessary both for assessing the prognosis and for delineating the appropriate treatment. It is based on histologic evidence of amyloid deposits and characterization of the amyloidogenic protein. We prospectively evaluated the diagnostic performance of immunoelectron microscopy (IEM) of abdominal fat aspirates from 745 consecutive patients with suspected systemic amyloidoses. All cases were extensively investigated with clinical and laboratory data, with a follow-up of at least 18 months. The 423 (56.8%) cases with confirmed systemic forms were used to estimate the diagnostic performance of IEM. Compared with Congo-red-based light microscopy, IEM was equally sensitive (75% to 80%) but significantly more specific (100% vs 80%; P < .001). In amyloid light-chain (AL) amyloidosis, κ cases were more difficult to diagnose (sensitivity 71%), whereas the analysis of abdominal aspirate was informative in only 40% of patients with transthyretin amyloidosis. We found a high prevalence (20%) of a monoclonal component in patients with non-AL amyloidosis, highlighting the risk of misdiagnosis and the need for unequivocal amyloid typing. Notably, IEM identified correctly the specific form of amyloidosis in >99% of the cases. IEM of abdominal fat aspirates is an effective tool in the routine diagnosis of systemic amyloidoses.
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http://dx.doi.org/10.1182/blood-2014-11-609883 | DOI Listing |
Lipids Health Dis
January 2025
Department of Cardiology, West China Hospital, Sichuan University West China School of Medicine, 37 Guoxue Road, Chengdu, Sichuan, 610041, China.
Background: Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index's predictive value for adverse prognosis in patients with AF without diabetes are lacking.
View Article and Find Full Text PDFBest Pract Res Clin Rheumatol
January 2025
Department of Rheumatology and Immunology, Peking University People's Hospital, No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China; Beijing Key Laboratory for Rheumatism Mechanism and Immune Diagnosis (BZ0135), No. 11, Xizhimen South Street, Xicheng District, Beijing, 100044, China; Division of Rheumatology, Department of Medicine, University of Colorado, No. 11, Xizhimen South Street, Xicheng District, Aurora, CO, 80045, USA. Electronic address:
Rheumatoid arthritis (RA) is a complex autoimmune disease with growing evidence implicating the microbiota as a critical contributor to its pathogenesis. This review explores the multifaceted roles of microbial dysbiosis in RA, emphasizing its impact on immune cell modulation, autoantibody production, gut barrier integrity, and joint inflammation. Animal models reveal how genetic predisposition and environmental factors interact with specific microbial taxa to influence disease susceptibility.
View Article and Find Full Text PDFRMD Open
January 2025
Epidemiology and Health Services Research, German Rheumatology Research Center, Berlin, Germany.
Objective: To analyse work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs), namely rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and ANCA-associated vasculitis (AAV).
Methods: A cross-sectional sample of 16 421 patients from the National Database of the German Collaborative Arthritis Centers, aged <65 years were analysed. For each diagnosis, yearly rates of absenteeism, employment and disability pensions were analysed from 2010 to 2022.
Ann Vasc Surg
January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFRev Clin Esp (Barc)
January 2025
Servicio de Medicina Interna, Hospital Universitario General de Valencia; Grupo de trabajo de Insuficiencia Cardíaca yFibrilación Auricular de la SEMI (ICYFA), Spain. Electronic address:
This document provides a comprehensive analysis of the use of point-of-care ultrasound in heart failure (HF), offering detailed recommendations on echocardiography, lung ultrasound, and venous ultrasound. These advanced imaging techniques allow for an accurate, detailed, and non-invasive evaluation of heart failure, facilitating rapid and effective clinical decision-making. Echocardiography enables a rapid assessment of cardiac function at the point of care, enhancing traditional physical examination and being essential for the management of heart failure (HF).
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