DIAGNOSTIC-VALUE OF BONE-MARROW BIOPSY IN PATIENTS WITH RENAL-DISEASESECONDARY TO FAMILIAL MEDITERRANEAN FEVER

Systemic AA type amyloidosis with renal involvement is the major cause of morbidity and mortality in patients with familial Mediterranean fe ver (FMF). A histopathological examination is essential to achieve a d efinite diagnosis in systemic amyloidosis. The diagnostic yield of the procedure varies according to the biopsy site and renal biopsy has th e highest yield. On the other hand this procedure has its own complica tions and requires hospitalization of the patient. Alternative biopsy sites have been proposed with varying degrees of sensitivity and morbi dity to reduce the morbidity and mortality of solid organ biopsies. We performed bone marrow biopsies in 39 patients with FMF who had differ ent stages of renal disease. Thirty-one (79.5%) of the 39 specimens sh owed significant perivascular amyloid infiltration when stained with c rystal violet and Congo red. An immunoperoxidase stain with a monoclon al antibody proved that these deposits were AA type amyloid. We sugges t that bone marrow biopsy can be utilized for a safe and quick diagnos is of systemic amyloidosis in patients with FMF and renal disease.