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Carpal Tunnel Syndrome Due to Iatrogenic Amyloidosis After Domino Liver Transplantation From Hereditary Transthyretin Amyloidosis: A Case Report
Authors:Yuki Ohya  Masayoshi Tasaki  Shintaro Hayashida  Nobuhiro Katayama  Toru Tsuchida  Kazumi Kuriwaki  Mitsuharu Ueda  Yukihiro Inomata
Institution:1. Department of Surgery, Kumamoto Rosai Hospital, Kumamoto, Japan;2. Department of Morphological and Physiological Sciences, Graduate School of Health Sciences, Kumamoto University, Chuo-ku, Kumamoto-shi, Kumamoto, Japan;3. Department of Orthopedics, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan;4. Department of Diagnostic Pathology, Kumamoto Rosai Hospital, Yatsushiro, Kumamoto, Japan;5. Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Chuo-ku, Kumamoto-shi, Kumamoto, Japan
Abstract:BackgroundCarpal tunnel syndrome is the most common compression syndrome of the peripheral nerve. Transthyretin amyloidosis and dialysis-related β2-microglobulin amyloidosis are known causes of carpal tunnel syndrome.Case ReportA Japanese woman showed carpal tunnel syndrome 16 years after a domino liver transplantation (DLT) from the donor with hereditary transthyretin amyloidosis. DLT indication was congenital extrahepatic portosystemic shunt, and the patient had been put on maintenance hemodialysis because of chronic kidney disease 6 years before DLT. Moreover, the amyloid precursor protein of the patient was histologically confirmed not to be β2-microglobulin, but transthyretin.ConclusionsThe existence of amyloid was speculated when the patient who underwent DLT from hereditary transthyretin amyloidosis showed carpal tunnel syndrome. Additionally, elucidating the amyloid precursor protein when the patient has another cause of amyloidosis is necessary.
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