Carpal tunnel syndrome and associated symptoms as first manifestation of hATTR amyloidosis

Chafic Karam, Diana Dimitrova, Megan Christ, Stephen B. Heitner

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

BackgroundHereditary transthyretin amyloidosis (hATTR) is associated with significant morbidity and mortality. Early diagnosis and treatment are essential to improve patient's outcome. Carpal tunnel syndrome (CTS) is a common complication of hATTR amyloidosis. However, because CTS is also common in the general population, we wanted to assess whether CTS, when associated with systemic manifestations, could help direct physicians to screen for TTR gene mutation and early diagnosis.MethodsWe reviewed the charts and interviewed the patients with hATTR seen between 2017 and 2018. We noted the details of CTS diagnosis, treatment, and other systemic features of the disease.ResultsSeventeen of the 23 patients studied had CTS. CTS was the first manifestation of the disease in 10 of 17 patients. On average, CTS symptoms occurred 10.4 years before their diagnosis of hATTR amyloidosis. In 6 of 10 patients with CTS, the following systemic symptoms were present as the first manifestation: erectile dysfunction, dysautonomia, polyneuropathy, exercise intolerance, and gastrointestinal and ocular symptoms.ConclusionCTS occurs in most patients with hATTR amyloidosis and frequently precedes the hATTR diagnosis. Most patients with CTS preceding hATTR diagnosis have systemic features. Recognizing systemic features at the time of CTS presentation may help in early diagnosis of hATTR amyloidosis.

Original languageEnglish (US)
Pages (from-to)309-313
Number of pages5
JournalNeurology: Clinical Practice
Volume9
Issue number4
DOIs
StatePublished - Aug 1 2019

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Carpal Tunnel Syndrome
Amyloidosis
Early Diagnosis
Primary Dysautonomias
Polyneuropathies
Erectile Dysfunction
Exercise
Morbidity
Physicians
Mutation

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Carpal tunnel syndrome and associated symptoms as first manifestation of hATTR amyloidosis. / Karam, Chafic; Dimitrova, Diana; Christ, Megan; Heitner, Stephen B.

In: Neurology: Clinical Practice, Vol. 9, No. 4, 01.08.2019, p. 309-313.

Research output: Contribution to journalArticle

Karam, Chafic ; Dimitrova, Diana ; Christ, Megan ; Heitner, Stephen B. / Carpal tunnel syndrome and associated symptoms as first manifestation of hATTR amyloidosis. In: Neurology: Clinical Practice. 2019 ; Vol. 9, No. 4. pp. 309-313.
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