Benefits Of Using Abdominal Subcutaneous Tissue And...

Ideally biopsies of abdominal subcutaneous tissue and salivary glands should be used for the Congo red staining test, and it is positive if the sample has apple-green birefringence in appearance under polarized light. If the sample was inconclusive or negative, then the provider should have the affected organ biopsied to ensure an accurate diagnosis. The reason one should investigate for amyloid deposits via more invasive biopsy techniques is due to the higher risk of mortality associated with misdiagnosis and delayed or lack of treatment. If renal biopsies are warranted, sufficient amounts of amyloid deposits can be found around the glomerular basement membranes. Urine testing for paraprotein is not specific enough for the diagnosis of AL, for many gammopathies present with this in the urine. Once biopsies are positive, then the amyloid deposits should be tested via immunofluorescence microscopy to obtain valuable information regarding its makeup. Immunohistochemistry can be used as well, but it is not as successful in providing compositional information for AL as immunofluorescence. AL should be differentiated from the other forms of amyloidosis, such as hereditary amyloidosis, inflammatory amyloidosis, and hemodialysis-related amyloidosis. Randall-type light chain deposition disease (LCDD) should also be included in the differential (Desport et al., 2012). To Rule Out Differential Diagnoses Jerzykowska et al. (2014) stressed the importance of ruling out all other