• Dr. Vincenzo L'Imperio

Routine IF is less sensitive of MS in typing renal Ig amyloidosis

Background

Immunoglobulin amyloidosis represents the most frequent form of renal amyloidosis (80%) and its distinction from other forms of amyloidosis is crucial for the clinial management. Routine immunofluoresce can show false positive/negative that can affect the correct diagnosis


Take home messages

  • Laser capture microdissection followed by mass spectrometry was used to type 170 cases of renal amyloidosis

  • LMD/MS demonstrated higher sensitivity as compared to IF

  • 16 cases diagnosed as Ig-amyloidosis were considered negative in IF

  • False negative can be due to mutation of the light/heavy chain or conformational changes in amyloid deposits

  • LMD/MS demonstrated higher sensitivity as compared to IF

  • 5 cases were misdiagnosed as Ig-amyloidosis on the base of false positive IF (all AA amyloid cases by MS)

  • False positive can be due to nonspecific charge interaction between the amyloid and the reagent antibody or to the contamination of the amyloid deposits by serum proteins (especially in cases of AA amyloidosis)


https://www.kidney-international.org/article/S0085-2538(19)30611-8/fulltext


#renalpath #nephropath #glomerulonephritis #renalbiopsy #amyloidosis #proteomics #massspectrometry #LMDMS #immunofluorescence

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Sito della Scuola di Anatomia Patologica

dell'Università degli Studi di Milano-Bicocca

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