Amyloidosis: diagnosis and prognosis

All patients with amyloidosis must have Congo red-stained deposits demonstrating green birefringence under polarized light. Subcutaneous fat is the easiest source for such tissue. Amyloid deposits must be characterized to establish systemic or localized disease, and all forms of systemic amyloidosis must be classified using immunohistochemistry, immunofluorescence, genetic testing for mutations known to be associated with familial amyloidosis or mass spectroscopy techniques. Where available, serum amyloid P component imaging may be used to quantify the extent of amyloid deposition. Both echocardiography and magnetic resonance imaging are important tools for assessing the extent of cardiac amyloidosis and establishing the prognosis for patients with this disease.