Studies on amyloid deposition in the parathyroid glands of long-term dialysis patients

We investigated 50 parathyroidectomized patients on maintenance hemodialysis and found amyloid deposition in the parathyroid glands of 47 of them. Nine of the 47 patients underwent surgery for carpal tunnel syndrome, and amyloid deposition was found in the transverse carpal ligaments. Histological examination showed the presence of amyloid deposits in the capsular septal walls between nodules, and in the small artery walls of the parathyroid glands. Recent studies indicate that β2-microglobulin (β2-MG) is the major constituent protein in this new form of amyloidosis. The amyloid deposits in our studies were resistant to potassium permanganate (nonAA protein) and reacted with anti-human β2-MG antibody in immunohistochemical studies (peroxidase-antiperoxidase method, immunofluorescence method). These findings suggest that dialysis amyloidosis may be systemic, and that amyloid substance may be deposited in systemic organs.