Amyloid and non-amyloid carpal tunnel syndrome in patients receiving chronic renal dialysis.
To determine the prevalence of amyloid deposits among patients with carpal tunnel syndrome (CTS) receiving dialysis, and to investigate the factors associated with amyloid and non-amyloid CTS.
Subjects for this prospective study were dialysis patients who underwent surgery for CTS in the same surgical unit between 1989 and 1997.
CTS was diagnosed from clinical and electromyographic (EMG) findings.
Systematic standard radiographs and laboratory data were also obtained.
Surgical investigations included systematic macroscopic examination and biopsy of the epineurium, flexor retinaculum, synovium, and flexor tendon sheaths.
Samples were stained for amyloid and examined by plain and polarized light microscopy, immunohistochemistry, and electron microscopy.
Forty-one samples from 30 patients (11 bilateral cases) were examined.
Amyloid deposits were found in 26 samples from 18 patients (7 M, 11 F).
Fifteen samples from 12 patients (3 M, 9 F) showed no amyloid deposits.
Amyloid CTS was statistically significantly associated with arthralgia and longterm dialysis [mean 13.3 (range 5.5-23) vs 7.5 yrs (range 3 mo-14 yrs) ] in non-amyloid CTS.
Flexor tenosynovitis and carpal bone erosion occurred more frequently in amyloid CTS.
There were no statistically significant differences between the 2 groups in clinical, laboratory or EMG findings, type of dialysis membrane, or frequency of ipsilateral fistula.
Only amyloid CTS was recurrent. (...)
Mots-clés Pascal : Hémodialyse, Complication, Homme, Amyloïdose, Arthropathie, Association, Canal carpien syndrome, Facteur risque, Prévalence, Epidémiologie, Etude longitudinale, Protéine, Microglobuline bêta2, Compression, Epuration extrarénale, Métabolisme pathologie, Enzymopathie, Système nerveux pathologie, Nerf périphérique pathologie, Système ostéoarticulaire pathologie
Mots-clés Pascal anglais : Hemodialysis, Complication, Human, Amyloidosis, Arthropathy, Association, Carpal tunnel syndrome, Risk factor, Prevalence, Epidemiology, Follow up study, Protein, bêta2-Microglobulin, Compression, Extrarenal dialysis, Metabolic diseases, Enzymopathy, Nervous system diseases, Peripheral nerve disease, Diseases of the osteoarticular system
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0312019
Code Inist : 002B27B03. Création : 27/11/1998.