21. Atlas Of Pathology Picture of the heart affected by amyloidosis by the Urbana Atlas of Pathology. http://www.med.uiuc.edu/PathAtlasf/Atlas69.html

Back to Previous Image URBANA ATLAS OF PATHOLOGY Image Number 69 - Heart, amyloidosis Arrow 1 depicts the peripherally located nuclei in the cross section of cardiac muscle . Notice the wide spacing between the cardiac muscle cells. This is due to the deposition of amyloid seen for example at arrow 2. This is being viewed with non-polarized light. With this stain the amyloid is a light salmon pink. Click for image To Next Image To Table of Contents To Alphabetical Index To Start

22. Amyloidosis And Waldenstrom's Macroglobulinemia Gertz Et Al . amyloidosis and Waldenstr m's Macroglobulinemia Morie A. Gertz , Giampaolo Merlini and Steven P. Treon Abstract http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

23. Amyloidosis Symptoms, Diagnosis And Treatment Explains how amyloidosis results from protein antibodies accumulating on an organcausing diseases such as multiple myeloma and mad cow disease. http://www.information-on-amyloidosis.com/

Amyloidosis Symptoms, Diagnosis and Treatment Amyloidosis occurs when abnormal antibody proteins or other protein fragments build up in an organ. As the protein accumulates, organ function begins to decline. Amyloidosis can affect any organ. In its primary form, it is a serious but rare condition: only eight out of every million Americans are diagnosed every year. Its cause is unknown. Amyloid Antibodies and Bone Marrow The proteins that accumulate in organs are called amyloid proteins. In some cases, the amyloid proteins are abnormal antibodies produced by the bone marrow. Normal antibodies circulate in the blood and break down over time. Amyloid antibodies do not break down as easily. Instead, the antibodies accumulate in the bloodstream. The abnormal antibodies eventually leave the blood and are deposited in organs. Amyloidosis Can Affect Any Organ Amyloid deposits can build up in any organ in the body. The disease may affect a single organ, or it may be systemic , affecting organs throughout the body. The following areas of the body appear to be more susceptible to amyloid accumulation than others: adrenal glands brain heart kidneys liver lymph nodes muscle tissue nerves pancreas spleen thyroid.

24. Amyloidosis And Waldenstrom's Macroglobulinemia Gertz Et Al. 2004 amyloidosis and Waldenstr m's Macroglobulinemia Morie A. Gertz , Giampaolo Merlini and Steven P. Treon Abstract http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

25. Amyloidosis - MayoClinic.com amyloidosis causes an abnormal protein buildup in various organs that canpermanently damage them. http://www.mayoclinic.com/invoke.cfm?id=DS00431

26. AL Primary Cutaneous Amyloidosis A case study. Some very explicit pictures. http://matrix.ucdavis.edu/DOJvol1num2/amyloidosis/amyloidosis.html

(6) Long-term AL primary amyloidosis. A case report by Vera A. Chotzen M.D. Regina Gandour-Edwards M.D. Michael K. Zang M.D. Phil Vogt M.D. Dermatology Online Journal, December 1995 Volume 1, Number 2 ABSTRACT This is a case report of AL primary amyloidosis with involvement limited to the skin for more than twenty years before the development of internal organ involvement. The clinical features suggested the systemic form of amyloidosis, rather than that found with nodular cutaneous amyloidosis. Introduction Longstanding lesions of nodular amyloidosis even in the face of a negative workup for internal involvement, can be consistent with systemic disease. This is an example of a patient who had extensive cutaneous amyloidosis for twenty years before developing cardiac involvement which then lead to her death. Patients who present with cutaneous features of amyloidosis usually undergo an evaluation to categorize the disease. Skin biopsy with ultrastructural immunohistochemical stains can help confirm the presence and subtype of amyloid. Once a patient has been found to have cutaneous amyloidosis, an extensive workup must be done to evaluate patients for the possibility of systemic involvement. Workup for systemic disease includes: serum and urine immunoelectrophoresis, rectal mucosal or abdominal fat biopsy, bone marrow biopsy, CBC, chemistry panel, and skull and spine X-rays. The origin of the amyloid and the extent of internal involvement are used to determine the approach to treatment.

27. MedlinePlus Medical Encyclopedia Primary Amyloidosis Primary amyloidosis Contents of this page Illustrations. Alternative names. Definition. Causes, incidence, and risk factors. Symptoms http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

28. Amyloidosis - Rheumatoid Arthritis: Health And Medical Information About Rheumat Rheumatoid Arthritis symptoms, diagnosis, the causes and treatment with discussionsof other bone and joint health related issues. http://www.medicinenet.com/amyloidosis/article.htm

document.writeln(''); MedicineNet Home Rheumatoid Arthritis Home Page > Amyloidosis Search Tips Printer-Friendly Format FREE Newsletters Email to a Friend ... Next Amyloidosis Medical Author: William C. Shiel Jr., MD, FACP, FACR What is amyloidosis? What are symptoms of amyloidosis? How is amyloidosis diagnosed? ... Amyloidosis At A Glance What is amyloidosis? Amyloidosis is a group of diseases that result from the abnormal deposition of a particular protein, called amyloid, in various tissues of the body. Amyloid protein can be deposited in a localized area, and may not be harmful or only affect a single tissue of the body. This form of amyloidosis is called localized amyloidosis. Amyloidosis that affects tissues throughout the body is referred to as systemic amyloidosis. Systemic amyloidosis can cause serious changes in virtually any organ of the body. Amyloidosis can occur as its own entity or "secondarily" as a result of another illness, including multiple myeloma , chronic infections (such as tuberculosis or osteomyelitis), or chronic inflammatory diseases (such as

29. High-Dose Melphalan And Autologous Stem-Cell Transplantation In HighDose Melphalan and Autologous Stem-Cell Transplantation in Patients with AL amyloidosis An 8-Year Study Martha Skinner, MD http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

30. Rheumatoid Arthritis: Health And Medical Information About Rheumatoid Arthritis amyloidosis Related Procedures Tests amyloidosis Related Diseases Conditions amyloidosis Related Doctor s Views Updates http://www.medicinenet.com/amyloidosis/

document.writeln(''); MedicineNet Home Rheumatoid Arthritis Home Page > Amyloidosis Search Tips What's Inside the Amyloidosis Health Center Amyloidosis Main Article 3 Medications related to Amyloidosis 2 Doctor's Views related to Amyloidosis 1 Health Features related to Amyloidosis ... Amyloidosis RSS feed Our Amyloidosis Main Article provides a comprehensive look at the who, what, when and how of Amyloidosis Arthritis and Pain Rheumatoid Arthritis Questions to Ask Your Doctor Arthritis Health e-Tools Amyloidosis related Doctor's Views Doctor: Getting the Most from Your Doctor’s Appointment How to Choose a Doctor Amyloidosis related Health Features Doctor: Checklist to Take To Your Doctor's Appointment Amyloidosis related Medications Chemotherapy colchicine, Colchicine melphalan-oral, Alkeran Terms related to Amyloidosis: Medications MedTerms Medical Dictionary Home Help ... Rheumatoid Arthritis Home Page Allergies Alzheimer's Arthritis Asthma Blood Pressure Cancer Cholesterol Chronic Pain Crohn's Disease Depression Diabetes Dictionary Digestion Eyesight First Aid Healthy Kids Healthy Living Heart Hepatitis C HIV/AIDS Liver Lung Cond.

31. Atlas Of Pathology A gross specimen of a liver by Urbana Atlas of Pathology. http://www.med.uiuc.edu/PathAtlasf/Atlas67.html

Back to Previous Image URBANA ATLAS OF PATHOLOGY Image Number 67 - Liver, amyloidosis This is a gross specimen of a liver. In comparison to a normal liver, this one has a gray-red and glassy appearance. This is especially noticeable in the areas to the right and left of the "6" mark on the ruler. Had this liver been stained with Lugol's solution, (an iodine containing solution) the amyloid would have stained a mahogany brown. Click for image To Next Image To Table of Contents To Alphabetical Index To Start

32. Amyloidosis And The Respiratory Tract Gillmore And Hawkins 54 amyloidosis and the respiratory tract Julian D Gillmore, Philip N Hawkins http://tmsyn.wc.ask.com/r?t=an&s=hb&uid=24312681243126812&sid=343126

33. Amyloidosis Why do some dogs with FSF get amyloidosis and others don t? The preciseincidence of amyloidosis in SharPei is impossible to determine at this time. http://home.olemiss.edu/~lwaej/sharamli.html

AMYLOIDOSIS An Article by Linda Tintle, DVM Published in the July/August 1993 issue of The Barker What is Amyloidosis? A generic term for a collection of diseases that result in the abnormal deposition of amyloid protein throughout the body. How is Amyloid Made? When inflammation occurs, certain chemicals are produced and released into the blood. These chemicals of inflammation are called the Acute Phase Reactant Proteins (APP). After the inflammation has gone away, the APP are broken down by the body and excreted. Dogs (or people) with amyloidosis can't break these APP down into excretable form and instead turn it into Amyloid AA and dump it outside the cells but still within the body. Why does the Amyloid make them sick? Amyloid is constantly deposited outside the cells. It builds up like a garbage heap in an alley vay until it starts to squeeze the adjacent cell walls. The compressed cells can't work properly. The damage or disease that results depends on what kinds of body cells are most severely damaged or killed. Kidncys can't heal themselves by growing new kidney cells. If a kidney cell dies, it is gone for good and can't be replaced. This is why the amyloid protein usually causes kidney failure first.

34. THE MERCK MANUAL, Sec. 2, Ch. 18, Amyloidosis The Merck Manual A discussion about amyloid production, the different types of this disease and their signs, symptoms, diagnosis and treatments. http://www.merck.com/pubs/mmanual/section2/chapter18/18a.htm

var locationOverride = "http://www.merck.com/pubs/"; This Publication Is Searchable The Merck Manual of Diagnosis and Therapy Section 2. Endocrine And Metabolic Disorders Chapter 18. Amyloidosis Topics [General] [General] Amyloidosis: Accumulation in the tissues of various insoluble fibrillar proteins (amyloid) in amounts sufficient to impair normal function. Etiology, Pathophysiology, and Classification The cause of amyloid production and its deposition in tissues is unknown. In the different biochemical types of amyloidosis, etiologic mechanisms may vary. For example, in secondary amyloidosis (see below Three major types of amyloid and several less common forms have been defined biochemically. The first type, which has an N-terminal sequence that is homologous to a portion of the variable region of an immunoglobulin light chain, is called AL and occurs in primary amyloidosis and in amyloidosis associated with multiple myeloma. The second type has a unique N-terminal sequence of a nonimmunoglobulin protein called AA protein and occurs in patients with secondary amyloidosis. The third type, which is associated with familial amyloid polyneuropathy, is usually a transthyretin (prealbumin) molecule that has a single amino acid substitution. Other hereditary amyloids have been found to consist of mutant gelsolin in some families, mutant apolipoprotein A-I in several others, and other mutant proteins in hereditary cerebral artery amyloid. In the amyloid associated with chronic hemodialysis

35. POEMS Syndrome Treatment Options At Mayo Clinic Mayo Clinic Rochester answers questions on amyloidosis including what it is, who gets it, what its symptoms are, diagnosis, and treatment. http://www.mayoclinic.org/poems-rst/

Home About Mayo Clinic Jobs Contact Us Mayo Clinic Locations: Arizona Florida Minnesota Mayo Clinic ... Medical Services POEMS Syndrome POEMS Syndrome Overview Symptoms Diagnosis Treatment Options ... Medical Services Treatment of POEMS Syndrome at Mayo Clinic (Synonyms: Crow-Fukase syndrome, PEP syndrome, Shimpo syndrome and Takatsuki syndrome) Patients with POEMS syndrome experience an integrated approach to diagnosis and treatment at Mayo Clinic. Working together, Mayo specialists develop a treatment plan based on the patient's needs and health issues. In some cases, patients with POEMS syndrome can receive a bone marrow transplant through Mayo Clinic's Transplant Center. Mayo is active in research on this disorder. Diagnosis POEMS syndrome is so rare that physicians who do not have experience with the disease may miss the diagnosis. Physicians at Mayo Clinic have the skills and experience necessary to diagnose this rare condition. The overgrowth of plasma cells can often be detected by finding an abnormal protein in the blood or urine, by an abnormality on a bone X-ray and/or a bone marrow biopsy. Read more about diagnosis of POEMS Syndrome Treatment Options Because POEMS syndrome is a multisystem disease, hematologists at Mayo Clinic gather neurologists, endocrinologists, radiation oncologists, physical therapists and other specialists to develop a comprehensive treatment approach. Treatment options include radiation therapy, corticosteroids, chemotherapy, a bone marrow transplant, hormone replacement therapy and physical therapy. Read more about

36. AL Primary Cutaneous Amyloidosis This is a case report of AL primary amyloidosis with involvement limited to the skin Patients who present with cutaneous features of amyloidosis usually http://dermatology.cdlib.org/DOJvol1num2/amyloidosis/amyloidosis.html

(6) Long-term AL primary amyloidosis. A case report by Vera A. Chotzen M.D. Regina Gandour-Edwards M.D. Michael K. Zang M.D. Phil Vogt M.D. Dermatology Online Journal, December 1995 Volume 1, Number 2 ABSTRACT This is a case report of AL primary amyloidosis with involvement limited to the skin for more than twenty years before the development of internal organ involvement. The clinical features suggested the systemic form of amyloidosis, rather than that found with nodular cutaneous amyloidosis. Introduction Longstanding lesions of nodular amyloidosis even in the face of a negative workup for internal involvement, can be consistent with systemic disease. This is an example of a patient who had extensive cutaneous amyloidosis for twenty years before developing cardiac involvement which then lead to her death. Patients who present with cutaneous features of amyloidosis usually undergo an evaluation to categorize the disease. Skin biopsy with ultrastructural immunohistochemical stains can help confirm the presence and subtype of amyloid. Once a patient has been found to have cutaneous amyloidosis, an extensive workup must be done to evaluate patients for the possibility of systemic involvement. Workup for systemic disease includes: serum and urine immunoelectrophoresis, rectal mucosal or abdominal fat biopsy, bone marrow biopsy, CBC, chemistry panel, and skull and spine X-rays. The origin of the amyloid and the extent of internal involvement are used to determine the approach to treatment.

37. AMYLOIDOSIS - Any Suggestions For A 66 Year Old Male I have a faint memory of retinoids in systemic amyloidosis. I have found theyatleast help in cutaneous amyloidosis, where PUVA works extremely http://dermatology.cdlib.org/rxderm-archives/amyloidosis

AMYLOIDOSIS - Any suggestions for a 66 year old male patient I saw last week with systemic amylodosis - although he has significant proteinuria and Any suggestions for a 66 year old male patient I saw last week with systemic amylodosis - although he has significant proteinuria and moderate anemia the major problem for him is the pruritus (an interesting point which must be made over and over again - whatever the insurance companies think of our value, the patients do understand it) - before he came to me he was seen by many of our colleagues who have used all types of topical steroids and many antihistamines without success Irwin Freedberg - Besides UV as suggested, I have a faint memory of retinoids in systemic amyloidosis. I have found they atleast help in cutaneous amyloidosis, where PUVA works extremely well-ablates the lesions and the itch. You might experiment with the narcotic antagonists, as they are quite safe, and come in several different formulations at this time-possilbly even as a patch. This is a great case for Haines Ely-maybe one of his old treatises mentions pruritis. Wouldn't it be amazing if in his honor Trental would work in whatever cascade is involved in the pruritis-of course I would be game to try it if there were free samples around. Cholestyramine works in DH itch, in a way not related to bile acids etc. It extinguished the itch and lesions in a patient of mine who had a not so occult squamous cell metastatic, which was the etiology of the DH some how. Empirically try it as well? Diane Thaler We have a 50 year old woman of asian Indian extraction with Lichen Amyloidosis and no remarkable systemic findings. It is on the lower legs and has been resistant to Topical steroids including Temovate with occlusion. Does anyone have any therapeutic suggestionsit is very uncomfortable to her. John Uhlemann - Intralesional steroids always have worked for me. Usually done monthly with Kenalog 10mg/cc, up to 2cc at a time. gary salenger Lichen Amyloidosis - Cordran (Drenison, flurandrenolide) Tape works well, and protects the skin while keeping it hydrated. Kevin C. Smith MD FRCPC - I tried everything in the world on a lovely young woman in her 20's, and the only thing that worked, and absolutely, was PUVA. We sunscreened the rest of her body. Diane Thaler You could try topical retinoic acid with topical corticosteriods. Another alternative is low dose cyclophosphamide (50mg p.o. daily), for 6 months to a year or till the therapeutic response plateaus. Friction has been known to aggravate the condition some times. Advise the patient to avoid using a pumice stone or body sponge while bathing, in case she does so. If medical treament fails, the papular lesions could be dermabraded. Belinda Vaz We find Tigason (etretinate) 0.5-1.0 mg/kg/day in divided dose works effectively in several cases recently. Patients usually respond within 4-6 weeks. We are now collecting a series of cases. It is a rather common disease herein Taiwan. Though excoriation and rubbering worsens the disease, certain races (including Orientals) are more susceptible to cutaneous amyloid formation. Endogenous factors may play a more important role than exogenous. An well-written book with in-depth information concerning amyloidosis was written by professor Chu-Kwan Wong in Taiwan several years ago. Maybe you can find it in your medical library. We usually treat the patient with topical potent steroid and or Retin-A 0.05% in the beginning. It works fairly well for most patients, however, it usually takes several weeks to respond. Remember to instruct patients not to "rub in" the medication since many of them believe rubbing enhances drug absorption. For those recalcitrant cases, dermabrasion helps, not to wonder,it recurs often. We recently find Tigason (etretinate)0.5-1.0 mg/kg/day helps as I mentioned before. I have'nt try PUVA before. I would like to try it in the near furture. I don't think it is a form of Atopy, at least of my experience in Chinese patients. Are there any reports mentioned about this? Tak-Wah Wong M.D. - Lichen amyloidosis responds to topical DMSO. The stuff is sold in health food stores and veteranary supply houses here in the USA. I rearely recommend this except in lichen amyloidis of the shins. It works. Aplly BID. Haines Ely

38. Amyloidosis Treatment At Mayo Clinic amyloidosis treatment for abnormal protein deposited in the body s tissues ororgans at Mayo Clinic. http://www.mayoclinic.org/amyloidosis/

Home About Mayo Clinic Jobs Contact Us Mayo Clinic Locations: Arizona Florida Minnesota Mayo Clinic ... Medical Services Amyloidosis Amyloidosis Overview Treatment Options Appointments Clinical Trials ... Medical Services Treatment of Amyloidosis at Mayo Clinic Mayo Clinic is one of a few medical centers in the United States studying the diagnosis and treatment of amyloidosis. More than 1,000 patients with amyloidosis were treated at Mayo Clinic in 2004. As a result of many years of research, Mayo Clinic offers a number of new therapies that are not widely available. These treatments range from stem cell transplantation, an area in which Mayo Clinic is among the most experienced in the world, to medications (not available commercially) which have shown promise in testing in Mayo Clinic's research laboratories. Mayo Clinic continually develops new clinical trials for the treatment of amyloidosis. No one therapy is appropriate for all people. Different specialists work together to ensure that each person receives therapy appropriate for the extent and type of his or her disease. Each treatment team includes a specialist experienced in caring for people who have amyloidosis. Diagnosis Diagnosis of primary amyloidosis is based on finding amyloid deposits in organs or other body tissues. A physician will first perform a thorough physical examination to find out if the organs are functioning properly. Blood, urine and bone marrow tests may be done. A small tissue sample (biopsy) may be taken from the rectum, abdominal fat or bone marrow. These biopsies are relatively minor procedures done in an outpatient setting with a local anesthetic (numbing medication). Occasionally, biopsies are taken from the liver, nerve, heart or kidney to help diagnose the organ affected by amyloidosis. Such biopsies are done with a local anesthetic and sedation; rarely is hospitalization required. Only bone marrow tests or biopsies of tissue can positively establish the diagnosis of amyloidosis and classify the type.

39. Amyloid Research Group Of Indiana University This site defines amyloidosis and describes current research as well as treatment options. It also introduces the personnel and facilities of the center. http://www.iupui.edu/~amyloid

Amyloid Research Group Indiana University School of Medicine What is Amyloidosis? Meet the department Created by Kamran on January 10, 2000 Last update on December 09, 2004 URL: http://www.iupui.edu/~amyloid email

40. Amyloid Late onset vitreous amyloidosis; Motor Sensory neuropathy ACys (amyloidosisVI), Cerebral amyloid angiopathy, Cystatin C http://www.neuro.wustl.edu/neuromuscular/nother/amyloid.htm

Front Search Index Links ... Patient Info AMYLOIDOSIS General clinical features Acquired PNS amyloidosis: AL CNS Amyloidosis Hereditary PNS amyloidosis ... Pathology GENERAL FEATURES Cause Locations Most disorders Extracellular spaces of tissues Inclusion body myositis : Intraccellar Polyneuropathy Small fiber sensory loss Carpal tunnel syndrome Autonomic neuropathy Systemic manifestations Myopathy Myelopathy Cardiomyopathy Ophthalmologic Renal failure Amyloidoma Electrophysiology Axonal, sensory, small fiber neuropathy Carpal tunnel syndrome Associated serum antibody: ? Serum M-Protein : Common in acquired disorders Pathology Congo red positive deposits: Red-Green birefringent with polarized light Located in connective tissue and vessel walls Treatment Liver transplantation in hereditary forms ? Immunosuppression in acquired forms ACQUIRED AMYLOIDOSIS Protein Clinical Most common in middle aged males Associated disorders Paraproteinemia ( M-protein) Most common in nephrotic syndrome Least common in polyneuropathy Light chain in 1/3 Intact immunoglobulin in 2/3 Multiple myeloma : May present 10-81 months after diagnosis of AL Polyneuropathy: Occurs in 20% of patients with light chain amyloid Distal; Symmetric

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