Table 2.

List of investigations required for work up of amyloidosis

For establishing diagnosis and typing of amyloid

Target organ or surrogate site (abdominal fat pad) biopsy

H & E and Congo red stain

IHC/Immunoelectron microscopy/proteomic study for amyloid typing

Serum protein electrophoresis (SPEP),Immunofixation electrophoresis (IFE), Serum free light chain assay (sFLC) for evidence of monoclonal plasma cell proliferation

Bone marrow aspirate and biopsy for clonal plasma cells

Mutation studies for various hereditary amyloidosis

Work up for rheumatoid arthritis, tuberculosis and other inflammatory conditions associated with AA amyloidosis

For confirming systemic involvement, assess distribution and complications

Renal function test

24 h urine protein/albumin

MRI/ECHO for cardiac involvement

Pro NT-beta natriuretic peptide

ECG

USG/CT scan for liver span

Alkaline phosphatase

X ray or CT scan of lung

GIT biopsy with evidence of amyloid

SAP scintigraphy/technetium scintigraphy

Coagulation screen