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Path - Amyloid (ii) (Morphology (spleen (large, pale, grey, waxy, deposits…
Path - Amyloid (ii)
Morphology
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kidney
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deposits principally in bowman's capsule, glomeruli, interstitial peritubular tissue, vessel walls
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liver
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deposits in perisinusoidal space of Disse, hepatic parenchyma + sinusoids
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also in adrenals, thyroid, pit, pancreas (DM), GIT (get rectal Bx), tongue (macroglossia), synovial tissue (carpal tunnel syndrome)
3 most common types
Amyloid light chain (AL)
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many patients have monoclonal B cell prolif (abnormally high Ig, produces an M proteins seen on serum electrophoresis)
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systemic, but kidneys + heart usually involved
incurable, treat underlying disease (e.g. multiple myeloma with chemo/BM transplant)
Amyloid Associated (AA)
due to continuous overproduction of acute phase proteins (precursor = serum amyloid associated, SAA) by the liver
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secondary to inflamm conditions (RA, TB, osteomyelitis, IBD, ankylosing spondylitis - type of arthritis with long term inflamm of joints of spine)
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if untreated significant mortality (infection, renal/heart failure, bowel perforation, GI bleeding)
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