1/28. Systemic amyloidosis and sacroiliitis in a patient with systemic lupus erythematosus.We report a case of a 25-year-old female with juvenile onset systemic lupus erythematosus who developed systemic secondary amyloidosis with renal and gastrointestinal involvement. She has also had radiological signs of bilateral asymptomatic sacroiliitis without lower back pain or hla-b27 antigen.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/28. An evaluation of antigen retrieval procedures for immunoelectron microscopic classification of amyloid deposits.The advantages of using immunoelectron microscopy in amyloid research and surgical pathology for the classification of amyloid deposits are well documented. The aim of this study was to improve single-labeling postembedding immunostaining by testing different antigen retrieval (AR) techniques. Etching and AR procedures were applied to sections from aldehyde-fixed and Epon-embedded autopsy specimens of patients who had suffered from generalized AA amyloidosis, systemic senile ATTR amyloidosis, or generalized kappa-light chain amyloidosis. The procedures used were no AR, H(2)O(2), saturated aqueous sodium metaperiodate (mPJ), heating in deionized water (dH(2)O), heating in sodium citrate buffer (SCB), heating in EDTA (each 91C, 30 min), and combinations of etching and heating. Little effect was evident after treatment with H(2)O(2), mPJ, and heating in dH(2)O, but the signal density markedly increased after heating in 1 mM EDTA. heating in SCB affected immunolabeling with anti-transthyretin and anti-kappa-light chain, whereas no effect was achieved for immunolabeling with anti-AA amyloid. We concluded that AR may significantly improve immunostaining of specimens that have undergone conventional fixation and embedding procedures for electron microscopy. The effect of AR on the detection of amyloid fibril proteins was probably mediated in part through chelation or binding of metal ions by the AR medium. (J Histochem Cytochem 47:1385-1394, 1999)- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
3/28. Localized amyloidosis of seminal vesicle and vas deferens: report of two cases.We reported localized amyloidosis involving seminal vesicles and vasa deferentia, which was found in two patients with prostatic adenocarcinoma. A 60-yr-old (Case 1) and a 59-yr-old (Case 2) man came to our hospital with elevation of serum prostate-specific antigen (PSA) and biopsy proven carcinoma, respectively. MRI revealed multiple irregular foci of low signal intensity in the prostates as well as in both seminal vesicles and vasa deferentia on T2-weighted imaging, suggesting prostatic carcinoma with extension to both seminal vesicles and vasa deferentia in both cases. Under the clinical diagnosis of stage III prostatic adenocarcinoma, a radical prostatectomy was performed in both patients. Microscopically, Gleason score 7 adenocarcinoma was observed in both patients. In addition, isolated amyloidosis of both seminal vesicles and vasa deferentia was found without carcinoma involvement. Localized amyloidosis in the seminal vesicles, which is considered as senile process, has been occasionally reported in the autopsy and in the surgical specimens. Amyloid deposition in the vas deferens has also been reported in the literature, however, the deposition mimicking extension of carcinoma has not been reported. In this report, two cases of isolated amyloidosis of the seminal vesicles and vasa deferentia are described with electron microscopic study and literature review.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/28. Localised alveolar-septal amyloidosis with hypersensitivity pneumonitis.Localised alveolar-septal amyloidosis has been thought irreversible. A woman exposed to the dust of sea-snail shells during the manufacture of nacre buttons had clinical and immunological features typical of hypersensitivity pneumonitis; however, transbronchial lung biopsy showed alveolar-septal amyloidosis. There was no evidence of other diseases known to be associated with amyloidosis, nor were amyloid deposits found in other organs. After a year without exposure to the antigen there was no trace of either pneumonitis or amyloidosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/28. Extensive variant of cutaneous amyloidosis: report of a case with electron-microscopic and immunohistochemical studies of the basement membrane zone at sites of amyloid production.A 60-year-old Japanese female developed widespread lichenoid eruptions with pigmentation, which initially appeared in preceding erythematous skin lesions due to dermatomyositis. Thioflavine T and Dylon stainings, electron microscopy and immunohistochemistry revealed that thick amyloid deposits were present in the papillary dermis particularly beneath the epidermis. autopsy showed no evidence of systemic amyloidosis. Electron microscopy of the lesional skin disclosed the disturbance of lamina densa formation in the epidermal basement membrane zone (BMZ). There was disruption and dissociation of the lamina densa from the basal cell, and a lamina-densa-like substance was found in the amyloid deposits. Immunofluorescence and immunoelectron microscopy showed that type IV and VII collagens, LDA-1 antigen (a noncollagenous component of the BMZ) and laminin were distributed in irregular thick deposits along the BMZ and were also present within the amyloid itself. These findings indicate that morphological and immunohistochemical abnormalities of the lamina densa may be involved in amyloid production at the interface of the epidermis and dermis, at least in this case.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/28. Excessive fibrinolysis in amyloidosis associated with elevated plasma single-chain urokinase.Severe bleeding resulting from excessive fibrinolysis has been observed in patients with primary amyloidosis. The authors studied a patient with this hemostatic disorder before and during therapy with epsilon-aminocaproic acid. Excessive fibrinolysis was associated with depressed plasma concentrations of coagulation Factors XII, XI, high-molecular-weight kininogen, and Factors VIII and V; and plasminogen and alpha-2-plasmin inhibitor. These deficiencies were corrected with treatment. The functional and antigenic concentrations of tissue plasminogen activator and plasminogen activator inhibitor in the patient's plasma were normal. Urokinase-type activator activity and antigen were three to five times elevated in the patient's plasma. Results of immunoprecipitation showed that single-chain urokinase-type activator was the primary urokinase-type activator species in the patient's plasma. Excessive fibrinolysis in patients with amyloidosis results from increased plasma single-chain urokinase-type activator activity.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
7/28. Nail dystrophy and blisters as sole manifestations in myeloma-associated amyloidosis.We report the case of a 61-year-old Japanese man with IgG lambda-type multiple myeloma, who presented with nail dystrophy as the initial manifestation of systemic amyloidosis. Subsequently he developed bullous amyloidosis. This report documents these two rare signs of systemic amyloidosis and demonstrates the precise location of cutaneous blister formation and amyloid deposition by fluorescence antigen mapping and electron microscopy.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/28. "Occult" mastocytosis with activating c-kit point mutation evolving into systemic mastocytosis associated with plasma cell myeloma and secondary amyloidosis.A case of a 70-year-old man presenting with exsudative enteropathy due to light-chain-associated amyloidosis is reported. The diagnosis of systemic mastocytosis associated with IgG/lambda plasma cell myeloma and secondary generalised amyloidosis was carried out by morphological evaluation of bone marrow biopsy. The c-kit point mutation D816Y was detected by molecular analysis. Two years before, a cystadenolymphoma of the left parotid gland had been removed. A moderate increase of loosely scattered spindle-shaped mast cells, a subpopulation of them expressing CD25, an antigen that is not expressed by normal or reactive mast cells, was shown by retrospective analysis carried out on an intraparotideal lymph node. The c-kit mutation D816Y was shown by the molecular analysis of the lymph node. In summary, the notion that systemic mastocytosis may very rarely be associated with B cell neoplasms and that neoplastic mast cell infiltrates may be obscured because of only a minimal increase of atypical mast cells, which are outnumbered by other non-neoplastic cells in the same tissue, is supported by this case. This finding was preliminarily termed "occult" mastocytosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/28. Immunoglobulin heavy-chain-associated amyloidosis.Immunoglobulin- or multiple myeloma-associated amyloidosis has been distinguished by the tissue deposition of Congophilic, fibrillar protein consisting of light chains or light-chain fragments (AL amyloidosis). We now report the isolation and characterization of another form of immunoglobulin-associated amyloid obtained from a patient who had extensive systemic amyloidosis and in whom the amyloid deposits consisted not of light chains but rather of an unusual form of heavy chain. This component, isolated from splenic amyloid extracts, represented an internally deleted IgG1 heavy chain as evidenced by immunochemical, electrophoretic, and amino acid sequence analyses. A comparable immunoglobulin-related monoclonal protein, consisting only of IgG heavy chains, was present in the patient's urine. Based on serologic reactivity with a battery of anti-immunoglobulin antisera, these two immunoglobulin-related components were antigenically identical; however, when compared to normal IgG, both were deficient in Fc-associated gamma-chain determinants. The structural abnormality of the amyloid gamma-chain protein was further evidenced by SDS/PAGE and immuno-blotting analyses: An unusually low molecular mass of approximately 22 kDa was found for this material vs. the expected value of approximately 55 kDa for a normal gamma heavy chain. Despite the lack of certain Fc determinants, the amyloid and urinary heavy-chain proteins expressed the IgG1 subclass allotype marker G1m(a) located on the third constant region (CH3) domain of the internally deleted IgG1 heavy chains. That the amyloid protein contained an intact CH3 domain was established through amino acid sequence analyses of cyanogen bromide fragments and peptides generated by a lysine-specific protease. These studies also revealed that the gamma-chain amyloid protein contained the complete heavy-chain variable (VH) domain [including the diversity (DH) and joining (JH) segments] that was contiguous with the CH3 domain. The low molecular mass of the protein resulted from the total absence of the first (CH1), hinge, and second (CH2) heavy-chain constant regions. Such extensive CH deletions and the presence of a complete VH distinguish this amyloid-associated heavy chain from all other heretofore characterized gamma-heavy-chain disease proteins. This heavy-chain-related form of immunoglobulin-associated amyloidosis is tentatively designated AH amyloidosis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/28. Elevated urokinase-type plasminogen activator level and bleeding in amyloidosis: case report and literature review.Hyperfibrinolytic states are reported to be a cause of bleeding in patients with amyloidosis. We reviewed the literature on excessive fibrinolysis in association with amyloidosis and report our findings from a patient with idiopathic amyloidosis who developed a bleeding diathesis. Coagulation laboratory studies indicated elevated plasminogen activator levels associated with a reduction of plasminogen and alpha 2-plasmin inhibitor (alpha 2-PI) levels. The level of tissue-type plasminogen activator (t-PA) inhibitor and t-PA antigen were normal. However, the patient did have a five- to sevenfold increase in amidolytic activity for the urokinase substrate pyro-Glu-Gly-Arg-pNA (S-2444). This case therefore represents a novel example of a hyperfibrinolytic state associated with amyloidosis caused by elevated urokinase-type plasminogen activator (u-PA). Epsilon-amino caproic acid (EACA) therapy resulted in an increase in alpha 2-PI and plasminogen levels and effectively reduced the blood loss. Hyperfibrinolytic states in amyloidosis have now been reported to be due to elevated t-PA and u-PA and depleted t-PA inhibitor.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
| | Next -> |