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Transthyretin-derived amyloidosis: Probably a common cause of lumbar spinal stenosis
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
2014 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 119, no 3, 223-228 p.Article in journal (Refereed) Published
Abstract [en]


Senile systemic amyloidosis (SSA) derived from wild-type transthyretin is a fairly common condition of old individuals, particularly men. The main presentation is by cardiac involvement, which can lead to severe restrictive cardiomyopathy. SSA is, however, a systemic disease, and amyloid deposits may appear in many other tissues but are thought to be without clinical symptoms outside the heart. Amyloid is a very common finding in cartilage and ligaments of elderly subjects, and transthyretin has been demonstrated in some deposits. Lumbar spinal stenosis is also a condition of usually elderly individuals in whom narrowing of the lumbar spinal canal leads to compression of nerves to the lower limbs.

Results. We questioned whether lumbar spinal stenosis sometimes could be a manifestation of undiagnosed SSA. In this first report we have studied the presence of amyloid in material obtained at surgery for spinal stenosis in 26 patients. Amyloid was found in 25 subjects. Transthyretin was demonstrated immunohistochemically in 5 out of 15 studied resected tissues. Four of the positive materials were analyzed with Western blot revealing both full-length transthyretin (TTR) and C-terminal TTR fragments, typically seen in SSA.

Conclusion. We conclude that lumbar spinal stenosis quite frequently may be a consequence of SSA and that further studies are warranted.

Place, publisher, year, edition, pages
2014. Vol. 119, no 3, 223-228 p.
Keyword [en]
apolipoprotein A-I, lumbar spinal stenosis, senile systemic amyloidosis, transthyretin
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-92642DOI: 10.3109/03009734.2014.895786ISI: 000340110800002PubMedID: 24620715OAI: diva2:747869
Available from: 2014-09-17 Created: 2014-09-01 Last updated: 2015-12-16Bibliographically approved

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