Beta-2 Microglobulin Amyloidosis

  • Alan S. Cohen
  • Tsuranobu Shirahana
  • Martha Skinner


The frequent complications of the carpal tunnel syndrome and osteoarthropathy with long-term hemodialysis have received increasing attention in the last decade. The intimate association of amyloid deposits with these conditions has been revealed and the pathogenetic implications discussed (1–13). It has been only after the last International Symposium on Amyloidosis which was held in New York in 1984 (14) that the exact nature of the amyloid has been exploited.


Synovial Fluid Carpal Tunnel Syndrome Carpal Tunnel Amyloid Deposit Amyloid Fibril 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Altmeyer P, Kachel HG, Runne U: Micro-angiopathy, alterations of connective-tissue, and deposition of an amyloid-like material in patients with chronic renal-failure. Hautarzt 34:277 (1983)Google Scholar
  2. 2.
    Bardin T, Kuntz D, Zingraff J, Voisin MC, Zelmar A, Lansaman, J: Synovial amyloidosis in patients undergoing long term hemodialysis. Arthritis Rheum 28:1052 (1985)CrossRefGoogle Scholar
  3. 3.
    Brown EA, Gower PE: Joint problems in patients on maintenance henodialysis. Clin Nephrol 18:247 (1982)Google Scholar
  4. 4.
    Clanet M, Mansat M, Durroux R, Testut MF, Guiraud B, Conte RA: Syndrome du canal carpien, tenosynovite amyloide et hemodialyse periodique. Rev Neurol (Paris) 137:613 (1981)Google Scholar
  5. 5.
    Delmez JA, Holtmann B, Sicard GA, Goldberg AP, Harter HR: Peripheral nerve entrapment syndromes in chronic hemodialysis patients. Nephron 30:118 (1982)CrossRefGoogle Scholar
  6. 6.
    Durroux R, Benovaich L, Bouissou H, Mansat M, Clanet M: Tenosynovite du canal carpien et depots amyloides chez les insuffisants renaux chroniques hemodialyses. Nouv Press Med 10:45 (1981)Google Scholar
  7. 7.
    Herve JP, Cledes J, Bourbigot B, Guillodo MP, Legrand O, Pennec Y, Youinou P, Leroy JP: Systemic ainyloidosis in the course of maintenance hemodialysis. Nephron 40: 494 (1985)CrossRefGoogle Scholar
  8. 8.
    Hillion D, Villeboeuf J, Hillion Y, Nakamura S, Bruet A: Appearance of systemic amyloidosis in a chronic hemodialysis patient. Nephron 41: 127 (1985)CrossRefGoogle Scholar
  9. 9.
    Huaux JP, Noel H, Bastien P, Malghem J, Maldague B, Devogelaer JP, Nagant de Deuxchaisnes C: Amylose articulaire, fracture du col femoral, et hemodialyse periodique chronique. Rev Rheum Mal Oateoartic 52:179 (1985)Google Scholar
  10. 10.
    Kachel HG, Altmeyer P, Baldamus CA, Koch KM: Deposition of an amyloid-like substance as a possible complication of regular dialysis treatment. Contr Nephr 36:127 (1983)Google Scholar
  11. 11.
    Schwarz A, Keller F, Seyfert S, Poll W, Molzahn M, Distler A: Carpal tunnel syndrome: a major complication in long-term hemodialysis patients. Clin Nephrol 22; 133 (1984)Google Scholar
  12. 12.
    Spertini F, Wauters JP, Poulenas I: Carpal tunnel syndrome: a frequent, invalidating, long-term complication of chronic hemodialysis. Clin Nephrol 21:98 (1984)Google Scholar
  13. 13.
    Warren DJ, Otiemo LS: Carpal tunnel syndrome in patients on intermittent hemodialysis. Postgrad Med J 51:450 (1975)CrossRefGoogle Scholar
  14. 14.
    Glenner GG, Osserman EF, Benditt EP, Calkins E, Cohen AS, Zucker-Franklin D, ed: “Amyloidosis”, Plenum Press, New York (1986)Google Scholar
  15. 15.
    Shirahama T, Skinner M, Cohen AS, Gejyo F, Arakawa M, Suzuki M, Hirasawa Y: Histochemical and immunohistochemical characterization of amyloid associated with chronic hemodialysis as β2-microglobulin. Lab Invest 53:705 (1985)Google Scholar
  16. 16.
    Puchtler H, Sweat F, Levine M: On the binding of Congo red by amyloid. J Histochem Cytochem 10:355 (1962)CrossRefGoogle Scholar
  17. 17.
    Cohen AS: Amyloidosis. New Engl J Med 277:522, 574, 628 (1967)CrossRefGoogle Scholar
  18. 18.
    Cohen AS, Shirahama T, Sipe JD, Skinner M: Amyloid proteins, precursors, mediator, and enhancer. Lab Invest 48:1 (1983)Google Scholar
  19. 19.
    Shirahama T, Cohen AS, Skinner M: Inimunohistochemistry of amyloid, in: “Advances in Immunohistochemistry”, DeLellis RA, ed., Masson Publishing, New York (1984) p 277Google Scholar
  20. 20.
    Wright JR, Calkins E, Humphrey RL: Potassium permanganate reaction in amyloidosis. A histologic method to assist in differentiating forms of this disease. Lab Invest 36:274 (1977)Google Scholar
  21. 21.
    Gejyo F, Yamada T, Odani S, Nakagawa Y, Arakawa M, Kunitomo T, Kataoka H, Suzuki M, Hirasawa Y, Shirahama T, Cohen AS, Schmid K: A new form of amyloid protein associated with chronic hemodialysis waws identified as β2-microglobulin. Biochem Biophys Res Conm 129; 701 (1985)CrossRefGoogle Scholar
  22. 22.
    Gorevic PD, Casey IT, Stone WJ, DiRaimondo CR, Prelli FC, Frangione B: Beta-2 microglobulin is an amyloidogenic protein in man. J Clin Invest 76:2425 (1985)CrossRefGoogle Scholar
  23. 23.
    Govevic PD, Munoz PC, Casey TT, DiRaimondo CR, Stone WJ, Prelli FC, Rodrigues MM, Poulik MD, Frangione B: Polymerization of intact γ2-microglobulin in tissue causes amyloidosis in patients on chronic hemodialysis. Proc Natl Acad Sci USA 83:7908 (1986)CrossRefGoogle Scholar
  24. 24.
    Connors LH, Shirahama T, Skinner M, Fenves A, Cohen AS: In vitro formation of amyloid fibrils fron intact β2-microglobulin. Biochem Biophys Res Commun 131:1063 (1985)CrossRefGoogle Scholar
  25. 25.
    Linke RP, Bommer J, Ritz E, Waldherr R, Eulitz, M: Amyloid kidney stones of uremic patients consist of beta 2 microglobulin. Biochem Biophys Res Commun 136:665 (1986)CrossRefGoogle Scholar
  26. 26.
    Bardin T, Zingraff J, Shirahama T, Noel L-H, Droz D, Voisin M-C, Drueke T, Dryll A, Skinner M, Cohen AS, Kuntz D: Hemodialysis-associated amyloidosis and beta-2 microglobulin. Clinical and immunohistochemical study. Am J Med 83:419 (1987)CrossRefGoogle Scholar
  27. 27.
    Varga J, Idelson BA, Felson D, Skinner M, Cohen AS: Lack of amyloid in abdominal fat aspirates fron patients undergoing long-term hemodialysis. Arch Intern Med 147:1455 (1987)CrossRefGoogle Scholar
  28. 28.
    Duston MA, Skinner M, Shirahama T, Cohen AS: Diagnosis of amyloidosis by abdominal fat aspiration. Analysis of four year’s experience. Am J Med 82:412 (1987)CrossRefGoogle Scholar
  29. 29.
    Munoz-Gonez J, Gomez-Perez R, Sole-Aroues M, Llopart-Buisan E: Synovial fluid examination for the diagnosis of synovial amyloidosis in patients with chronic renal failure undergoing haemodialysis. Ann Rheum Dis 46:324 (1987)CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Alan S. Cohen
    • 1
    • 2
  • Tsuranobu Shirahana
    • 1
    • 2
  • Martha Skinner
    • 1
    • 2
  1. 1.Arthritis Center, Boston University School of MedicineUSA
  2. 2.Thorndike Memorial LaboratoryBoston City HospitalBostonUSA

Personalised recommendations