Jl. Dupond et al., VALUE OF ABDOMINAL FAT ASPIRATION AND LAB IAL SALIVARY-GLAND BIOPSY FOR THE DIAGNOSIS OF AMYLOIDOSIS IN ELDERLY - A PROSPECTIVE-STUDY IN 100 PATIENTS, La Revue de medecine interne, 16(5), 1995, pp. 314-317
Primary and secondary amyloidosis are not uncommun in aging dot the di
agnosis is rarely made on account of the risk of bleeding in the site
of biopsies and the difficulty to distinguish senile from systemic amy
loidosis on the biopsy samples. We have studied the frequency of amylo
id deposition in the abdominal fat aspirate (AFA), the labial salivary
gland (LSG), the temporal arteries (four cases), bone marrow (two cas
es), digestive tract (four cases) in 100 elderly patients (aged 80 or
greater). AFA was positive in 15 percent of the patients and LSG in 5%
; both samples were positive in 48. Four cases of systemic amyloidosis
were found (two of the AL and two of the the AA type). Sensitivity of
AFA was 75%, specificity was 87% and the positive predictive value wa
s 20%. The values were respectively 100%, 99%, 100% for LSG. In I I pa
tients whose AFA biopsies samples were singly positive, amyloid deposi
ts were found in temporal arteries in four of four cases. We conclude
that AFA is too sensitive for the diagnosis of systemic amyloidosis in
aging. The responsibility of senile amyloid deposition on AFA should
require further investigations. LSG biopsies seem to be a more reliabl
e test for the diagnosis of primary and secondary amyloidosis in elder
ly.