[ill]myloidosis is considered by many to be a rare disease. In a retrospective review by Alexanian al in this issue,1 30 cases of amyloidosis were [ill]gnosed during a 15-year span. Because symptoms [ill]re present for 20 months before diagnosis, the [ill]hors point out the need for better identification [ill]d earlier diagnosis.
Diagnosis of amyloidosis demands proof through a [ill]psy. Symptomatically uninvolved tissue (eg, rec[ill]n, subcutaneous fat,2 and bone marrow) or in[ill]ved tissue (eg, carpal ligament, sural nerve, endo[ill]ocardium, small intestine, kidney, and liver) may chosen, depending on risk and cost, until the [ill]gnosis is confirmed.
The detection of a monoclonal protein in the serum [ill]urine helps distinguish the more common primary [ill]yloidosis (AL) (amyloid light chain) from secondary amyloidosis (AA) and other forms of amyloi[ill]sis.3 Electrophoresis of serum and urine discloses a [ill]noclonal protein peak in about half of patients [ill]th AL while immunoelectrophoresis can detect a [ill]noclonal protein in