PMID- 33342448
OWN - NLM
STAT- MEDLINE
DCOM- 20211018
LR  - 20211018
IS  - 0317-1671 (Print)
IS  - 0317-1671 (Linking)
VI  - 48
IP  - 5
DP  - 2021 Sep
TI  - Utility of Neuropathy Screening for Wild-Type Transthyretin Amyloidosis Patients.
PG  - 607-615
LID - 10.1017/cjn.2020.271 [doi]
AB  - BACKGROUND: Wild-type transthyretin amyloidosis (wtATTR) is an important cause of 
      heart failure (HF); however, the prevalence and clinical significance of 
      neurologic complications remains uncertain. METHODS: This analysis reports 
      findings from a single-centre experience of routine neuropathy screening at the 
      time of wtATTR diagnosis by nerve conduction studies and neurologist assessment, 
      compared with age-matched controls. RESULTS: Forty-one wtATTR patients were 
      included, 39 (95%) males, mean age 78.4 +/- 7.7 years, 22 (54%) New York Heart 
      Association (NYHA) class III-IV HF, along with 15 age-matched controls (mean age 
      77.1 +/- 4.2 years, 80% male). Twenty-one (51%) wtATTR patients were diagnosed with 
      polyneuropathy, 15 (37%) with spinal stenosis, 36 (88%) with carpal tunnel 
      syndrome (CTS) and 14 (34%) with ulnar neuropathy. Comparison diagnoses among 
      controls were 1 (7%), 0, 1 (7%) and 3 (20%), respectively. Among patients with 
      NYHA class III-IV HF, 16 (73%) had polyneuropathy compared with 5 (26%) with 
      class I-II (p < 0.01), odds ratio of 7.5 (95% confidence interval 1.9-29.9). 
      After neuropathy screening, 19 (46%) patients were offered neurologic therapy 
      and/or additional diagnostic evaluation. This included CTS release surgery (16, 
      39%), neuropathic pain medication (3, 7%), nerve block (1, 2%), wrist splinting 
      (2, 5%) and foot care (1, 2%). Spine imaging was performed for 3 (7%) patients, 
      and deltoid muscle and sural nerve biopsy for 1 (2%) patient. CONCLUSIONS: 
      Screening of wtATTR patients for neurologic complications resulted in a 
      management change for nearly half. CTS, polyneuropathy and ulnar neuropathy were 
      common. This approach warrants consideration as part of routine assessment for 
      newly diagnosed wtATTR patients.
FAU - Russell, Angela
AU  - Russell A
AD  - Division of Neurology, Department of Clinical Neurosciences, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Hahn, Christopher
AU  - Hahn C
AD  - Division of Neurology, Department of Clinical Neurosciences, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Chhibber, Sameer
AU  - Chhibber S
AD  - Division of Neurology, Department of Clinical Neurosciences, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Korngut, Lawrence
AU  - Korngut L
AD  - Division of Neurology, Department of Clinical Neurosciences, University of 
      Calgary, Calgary, Alberta, Canada.
FAU - Fine, Nowell M
AU  - Fine NM
AD  - Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular 
      Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, 
      Canada.
LA  - eng
PT  - Journal Article
DEP - 20201221
PL  - England
TA  - Can J Neurol Sci
JT  - The Canadian journal of neurological sciences. Le journal canadien des sciences 
      neurologiques
JID - 0415227
RN  - Amyloidosis, Hereditary, Transthyretin-Related
SB  - IM
CIN - Can J Neurol Sci. 2021 Sep;48(5):597-598. PMID: 33431070
MH  - Aged
MH  - Aged, 80 and over
MH  - *Amyloid Neuropathies, Familial/complications/diagnosis/epidemiology
MH  - *Carpal Tunnel Syndrome/diagnosis/epidemiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Neurologic Examination
MH  - *Polyneuropathies
OTO - NOTNLM
OT  - Diagnosis
OT  - Management
OT  - Neuropathy
OT  - Wild-type transthyretin amyloidosis
EDAT- 2020/12/22 06:00
MHDA- 2021/10/21 06:00
CRDT- 2020/12/21 05:32
PHST- 2020/12/22 06:00 [pubmed]
PHST- 2021/10/21 06:00 [medline]
PHST- 2020/12/21 05:32 [entrez]
AID - S0317167120002711 [pii]
AID - 10.1017/cjn.2020.271 [doi]
PST - ppublish
SO  - Can J Neurol Sci. 2021 Sep;48(5):607-615. doi: 10.1017/cjn.2020.271. Epub 2020 
      Dec 21.