Abdominal Fat Aspiration Biopsy in Dialysis-Related Amyloidosis-Reply

In Reply.  —The letter of Arques et al adds information on additional patients who are receiving chronic hemodialysis and who have undergone abdominal fat aspirations for the diagnosis of amyloidosis. Twelve of 30 fat aspirates were positive, but are reported as often scant and difficult to detect. Their findings are intriguing and suggest that a positive abdominal fat aspirate may be more common in hemodialysis-associated amyloid than we found. It should be noted that false-positive readings may occur in laboratories where this test is performed infrequently, and that this is more likely to occur when looking for a "scant" deposit.We certainly agree that hemodialysis-associated amyloid fibril deposits can occur throughout the body, however, to a far lesser degree than in the other forms of systemic amyloidosis. This undoubtedly accounts for the infrequent finding of positive abdominal fat aspirates. We feel that both our series of patients and the series