Menu
Home
Specialties
Services
Contact Janssen
Login
Choose your language
Menu
Specialties
Services
Contact Janssen
Interesting Links
Choose your language
AMY DA site - i can identify - Video 2
Services
Media Center
It seems your browser is blocking 3rd party cookies which are required to display videos. To resolve this issue, please update your cookie settings to allow these 3rd party cookies.
Manage cookie settings
Chapters
00:00:15
The advice for the nephrologist to diagnose AL amyloidosis
00:00:19
earlier is severe nephrotic syndrome or massive proteinuria,
00:00:27
again, in the absence of diabetes, hypertension, rheumatologic conditions,
00:00:34
specifically if nephrotic syndrome is associated with massive albuminuria
00:00:40
of greater than 5 grams, greater than 10 grams.
00:00:44
Patients also have other organ system involvement with congestive heart failure,
00:00:49
autonomic neuropathy leading to postural hypotension, or low blood pressures.
00:00:55
Again, this constellation of these syndromes and these clinical features
00:00:59
should lead a nephrologist to suspect a systemic disease
00:01:05
and maybe a renal biopsy should be performed sooner
00:01:09
rather than later to diagnose AL amyloidosis.
00:01:14
Furthermore, 10% of patients with renal AL amyloidosis may not have
00:01:20
nephrotic syndrome, may not have albuminuria, or albumin spillage in the urine.
00:01:26
They could present just with worsening of renal function.
00:01:30
And in those cases, as well, renal biopsy would make the diagnosis
00:01:35
of AL amyloidosis with amyloid deposits
00:01:38
in the tubulointerstitial region rather than the glomeruli.
00:01:48
A lot, you know, cardiologists and nephrologists,
00:01:50
along with hematologists and neurologists
00:01:52
work very closely together, especially at the
00:01:56
Boston University Amyloidosis Center,
00:01:58
because the key to diagnosing AL cardiac amyloidosis is
00:02:03
is to recognize that these organs are being involved simultaneously.
00:02:07
First of all, realize that this is somebody who has worsening heart failure
00:02:11
with thick heart walls, who also has protein in their urine,
00:02:15
and all at once the differential shifts from
00:02:19
run-of-the-mill heart failure to something that is more,
00:02:23
that is rarer, like a systemic AL amyloidosis.
00:02:27
And so that happens all the time, and it involves a collaboration
00:02:30
between the nephrologist, the kidney specialist,
00:02:33
and the heart specialist to put their heads together and realize that
00:02:36
systemic AL amyloidosis is the common theme here.