Research Article
Volume 7 Issue 6 - 2020
Diversity of Cardiac Amyloidosis - A Comparative Histological, Histochemical, and Electron Microscopic Study of Systemic AA, AL and Isolated Atrial Myocardiocyte Associated (Atrial Natriuretic Factor-AANF) Amyloidosis
Miklós Bély1* and Ágnes Apáthy2
1Department of Pathology, Hospital of the Order of the Brothers of Saint John of God in Budapest, Hungary
2Department of Rheumatology, St. Margaret Clinic, Budapest, Hungary
*Corresponding Author: Miklós Bély, Department of Pathology, Hospital of the Order of the Brothers of Saint John of God in Budapest, Hungary.
Received: April 16, 2020; Published: May 27, 2020


Objective: This study focuses on various types of amyloidosis, characterized by amyloid A (AA), amyloid light chain l or k (ALl or ALk), amyloid transthyretin wild type (ATTRwt), amyloid b2microglobulin (Ab2M) and localized (isolated) myocardiocyte associated amyloid atrial natriuretic factor (AANF) protein deposits and discuss the possible involvement of the heart.

The aim our study was to describe a simple histochemical method for identification of systemic (AA, ALl or ALk, TTRwt, Ab2M) and localized myocardiocyte associated AANF deposits for general departments of pathology.

Patients and Methods: Autopsy and biopsy material of patients with systemic or isolated amyloidosis were studied in one institute by light, polarization, and electron microscopy.

Classic histological, histochemical, immunohistochemical and electron microscopical methods were used.

Results: All mentioned types of amyloid deposits were eosinophilic, congophilic and birefringent by light or polarization microscopy, respectively. The amyloid filaments or fibrils of various deposits revealed no morphologic difference electron microscopically. However, there was a difference between systemic AA, ALl or ALk, ATTRwt, Ab2M, and isolated AANF amyloidosis in relation to the blood vessels, in the pattern of deposition, in cellular response of phagocytes, in the histochemical and ultrastructural characteristics of amyloid deposits.

Conclusion: The histological, immunohistochemical, histochemical and ultrastructural characteristics of systemic and isolated amyloidosis are different.

With simple histochemical methods the most important types of amyloid deposits (systemic AA, ALl or ALk, ATTRwt, Ab2M and isolated AANF) may be differentiated.

The histochemical methods are recommended for general departments of pathology, especially for those laboratories, where genomic DNA sequence analysis or amino acid sequence identification techniques are not available.

Keywords: Systemic AA, ALl or ALk; ATTRwt; Ab2M; Isolated AANF Amyloidosis; Light and Electron Microscopy


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Citation: Miklós Bély and Ágnes Apáthy. “Diversity of Cardiac Amyloidosis - A Comparative Histological, Histochemical, and Electron Microscopic Study of Systemic AA, AL and Isolated Atrial Myocardiocyte Associated (Atrial Natriuretic Factor-AANF) Amyloidosis”. EC Cardiology 7.6 (2020): 36-59.

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