Low diagnostic yield of sural nerve biopsy in patients with peripheral neuropathy and primary amyloidosis

Zachary Simmons, Mila Blaivas, Arnold J. Aguilera, Eva L. Feldman, Mark B. Bromberg, Javad Towfighi

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Patients with primary amyloidosis may develop peripheral neuropathy as an early feature. Sural nerve biopsy is reported to be a sensitive method for diagnosing amyloidosis in such patients. We identified nine patients, ultimately diagnosed as having amyloidosis, who were referred for peripheral neuropathy of undetermined etiology. In six, a sural nerve biopsy demonstrated no amyloid. Subsequent examination of other tissue or of the contralateral sural nerve eventually resulted in the correct diagnosis. We conclude that sural nerve biopsy may be less sensitive than previously believed for the diagnosis of amyloidosis in patients with peripheral neuropathy secondary to amyloid. When the clinical suspicion of amyloidosis is high, a nondiagnostic sural nerve biopsy should not discourage the performance of further investigative studies.

Original languageEnglish (US)
Pages (from-to)60-63
Number of pages4
JournalJournal of the neurological sciences
Issue number1
StatePublished - Dec 1 1993


All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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