title: Early diagnosis of systemic amyloidosis by means of a transverse carpal ligament biopsy carried out during carpal tunnel syndrome surgery.
abstract: OBJECTIVE
  The systematic analysis of a carpal transverse ligament (CTL) sample obtained during routine carpal tunnel syndrome (CTS) surgery may constitute a method of early diagnosis for systemic amyloidosis.
  
  
  METHODS
  Prospective study carried out on 147 consecutive CTL samples collected from patients intervened for CTS at the University Hospital of León from April 2006 to May 2007. In those cases in which amyloid deposition was observed in the CTL sample, the study was completed with a fine needle aspiration biopsy (FNAB) of the subcutaneous fascia, using the Red Congo stain in both cases. Positive cases were referred to the Internal Medicine and/or Hematology departments, and their evolution was monitored for up to 8 years.
  
  
  RESULTS
  CTL amyloid deposition was observed in 29 patients (19.7%), with a FNAB only being performed in 19 of them (65.5%). The test was positive in 11 cases (57.9%), and 4 patients in this subgroup (3% of the total) developed events attributable to amyloidosis over the following 3 years.
  
  
  CONCLUSIONS
  A CTL routine biopsy carried out during CTS surgery may anticipate the systemic amyloidosis diagnosis.
authors.affiliation: Servicio de COT, Hospital Universitario de León, León, España. Electronic address: fdezfuertes@gmail.com.
authors.forename: Judit
authors.initials: J
authors.lastname: Fernández Fuertes
authors.affiliation: Servicio de Anestesiología, Hospital Universitario de León, León, España.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Rodríguez Vicente
authors.affiliation: Servicio de COT, Hospital Universitario de León, León, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sánchez Herráez
authors.affiliation: Servicio de COT, Hospital Universitario de León, León, España.
authors.forename: Luis Rafael
authors.initials: LR
authors.lastname: Ramos Pascua
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D001706:Biopsy; D002348:Carpal Bones; D002349:Carpal Tunnel Syndrome / Q000150:complications / Q000601:surgery*; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008022:Ligaments / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
keywords: Amiloidosis; Amyloidosis; Carpal tunnel syndrome; Diagnóstico precoz; Early diagnosis; Síndrome del túnel del carpo