%0 Journal Article
%T Minimally Invasive Minor Salivary Gland Biopsy for the Diagnosis of Amyloidosis in a Rheumatology Clinic
%A Ridvan Mercan
%A Berivan B£¿t£¿k
%A Mehmet Engin Tezcan
%A Arif Kaya
%A Abdurrahman Tufan
%A Mehmet Akif £¿zturk
%A Seminur Haznedaroglu
%A Berna Goker
%J ISRN Rheumatology
%D 2014
%R 10.1155/2014/354648
%X Background. Systemic amyloidosis is a potentially fatal condition, unless diagnosed and treated before development of irreversible organ damage. Demonstration of amyloid deposits within tissue biopsies is only definitive diagnostic method, which makes appropriate selection of biopsy site essential. Herein, we evaluated efficacy of minimally invasive minor salivary gland biopsy (MSGB) for the diagnosis of amyloidosis. Methods. We analyzed 37 biopsies taken from 35 patients. Suggestive findings for amyloidosis were significant proteinuria, renal impairment, refractory diarrhea, neuropathy, and restrictive cardiomyopathy. Minor salivary gland was the initial biopsy site in all subjects. When MSGB was negative but there was a high suspicion for amyloidosis, a kidney, duodenum, or rectal biopsy was performed for further investigation. Results. Mean age of patients was 45.4 and 21 were female. In 11 patients amyloidosis was diagnosed with MSGB. In overall 18 patients were diagnosed with amyloidosis. Sixteen of them were identified as being of AA type and two were AL type amyloidosis. The sensitivity of minimally invasive MSGB is 61.1% for diagnosing amyloidosis in this study. Conclusion. MSGB is a safe and simple method for the diagnosis of amyloidosis which can be performed in an outpatient setting. We suggest extensive use of this minimally invasive method. 1. Introduction Amyloidosis is a potentially fatal condition characterized by extracellular deposition of nonbranching protein fibrils in organs [1]. This devastating condition is mainly caused by plasma cell disorders and numerous inflammatory diseases including autoimmune and chronic infectious diseases [2, 3]. Demonstration of amyloid deposits in biopsy specimens is the only way of establishing the diagnosis of amyloidosis [4, 5]. Therefore, appropriate selection of biopsy site is essential. The sensitivity and specificity of histopathology varies greatly according to where the tissue biopsy is obtained [5, 6]. Sensitivity of biopsy samples from visceral organs is higher; however, it requires more invasive procedures with bearing higher risk of complications, such as bleeding, hematoma, and perforation. Abdominal fat pad, gingiva, and rectum are the most common initial biopsy sites because of their ease of accessibility, low complication rate, and lower costs [5]. However, diagnostic yield of these biopsies is somewhat lower compared to visceral organ biopsies. Minor salivary glands have parenchymal and secretory components with considerable blood supply. Therefore, labial salivary glands are a good
%U http://www.hindawi.com/journals/isrn.rheumatology/2014/354648/