{"id":1456,"date":"2019-06-04T17:22:44","date_gmt":"2019-06-04T15:22:44","guid":{"rendered":"http:\/\/reseau-amylose.org\/patient\/treating-amyloidosis\/everything-depends-on-the-type-of-amyloidosis"},"modified":"2019-06-04T17:22:44","modified_gmt":"2019-06-04T15:22:44","slug":"everything-depends-on-the-type-of-amyloidosis","status":"publish","type":"page","link":"https:\/\/reseau-amylose.org\/jesuispatient\/treating-amyloidosis\/everything-depends-on-the-type-of-amyloidosis\/","title":{"rendered":"Everything depends on the type of amyloidosis"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1456\" class=\"elementor elementor-1456 elementor-bc-flex-widget\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-75d15162 elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"75d15162\" data-element_type=\"section\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-no\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6c43559b\" data-id=\"6c43559b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2f51f6d0 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2f51f6d0\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a761522 elementor-widget elementor-widget-heading\" data-id=\"5a761522\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\"><h2 class=\"elementor-heading-title elementor-size-large elementor-inline-editing pen\" data-elementor-setting-key=\"title\" data-pen-placeholder=\"\u00c9crivez ici...\">Type de l'Amylose<\/h2><\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3c5e7881 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3c5e7881\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3a5a9ed7\" data-id=\"3a5a9ed7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a1dae3e elementor-widget elementor-widget-heading\" data-id=\"a1dae3e\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">Hereditary TTR Amyloidosis <\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e7b50f5 elementor-widget elementor-widget-text-editor\" data-id=\"e7b50f5\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h6>For more than a decade, the treatment for hereditary TTR amyloidosis has been liver transplantation which stops the liver from producing the mutated transthyretin, thereby stabilising the disease\u2019s progression, particularly the neurological effects. In some cases, specialist heart and liver teams will consider doing a double heart-liver transplant.<\/h6>\n<h6>Liver transplantation used to be the only therapeutic treatment for hereditary amyloidosis. It works by preventing the production of abnormal transthyretin. Now, new medications are in development and becoming more accessible. These medications aim to inhibit the development of amyloid deposits by making the transthyretin tetramers more stable. One of these treatments, Vyndaquel (Tafamidis), received market authorisation from the European Medicines Agency (EMA) in November 2011. It is currently only available in hospital pharmacies and must be prescribed by a neurologist affiliated with a specialist centre. It is aimed at patients who are able to walk without aid and have a known amyloid neuropathy.<\/h6>\n<h6>Other approaches to treatment, such as gene therapy, are being tested and developed at the moment, notably at Henri Mondor Hospital.<\/h6>\n<ul>\n<li>\n<h6>ISIS-TTRrx is used to treat hereditary amyloidosis which causes neurological damage. This compound inhibits the production of transthyretin.<\/h6>\n<\/li>\n<li>\n<h6>Tafamidis is used to treat hereditary and senile amyloidosis which damages the heart. This compound stabilises the transthyretin tetramers.<\/h6>\n<\/li>\n<\/ul>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-74c00a67 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"74c00a67\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-12b91325\" data-id=\"12b91325\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-759a4646 elementor-widget elementor-widget-video\" data-id=\"759a4646\" data-element_type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/www.youtube.com\\\/watch?v=bdHf6XL4uZo&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2facc4b4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2facc4b4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-234f462b\" data-id=\"234f462b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5b88a7c elementor-widget elementor-widget-heading\" data-id=\"5b88a7c\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">AL Amyloidosis <\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-64922bd3 elementor-widget elementor-widget-text-editor\" data-id=\"64922bd3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h6>Treating AL amyloidosis often involves chemotherapy in order to reduce or indeed suppress the plasma cells which produce the immunoglobulins responsible for amyloid deposition. The effectiveness of this treatment is tracked by measuring the immunoglobulin light chains and the normalisation of cardiac biomarkers (BNP, NTproBNP and troponin).<\/h6>\n<p>&nbsp;<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-801f88e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"801f88e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-48ab065f\" data-id=\"48ab065f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-e91549d elementor-widget elementor-widget-heading\" data-id=\"e91549d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h6 class=\"elementor-heading-title elementor-size-default\">Senile Amyloidosis <\/h6>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1446dffd elementor-widget elementor-widget-text-editor\" data-id=\"1446dffd\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h6>Diagnosing senile amyloidosis is often a process of elimination for patients that have heart failure and cardiac hypertrophy. Senile amyloidosis can only be conclusively diagnosed if the myocardial biopsy detects transthyretin amyloid deposits. However, performing a myocardial biopsy on older patients presents an ethical dilemma due to the potential complications (myocardial perforation, lesions in the tricuspid valve). Histological proof of amyloid deposits in senile systemic amyloidosis can be obtained through biopsies of non-cardiac tissue (salivary glands, carpal tunnels, rectum, abdominal fat, etc.) and subcutaneous fat. However, non-cardiac biopsies are less effective at detecting senile systemic amyloidosis than other types of amyloidosis, so a negative result does not eliminate the possibility of senile systemic amyloidosis. Forms of senile amyloidosis can also be localised in the previously mentioned tissues without affecting the heart. However, this does not mean that the heart will not be affected some years later. Patients that have negative biopsies for transthyretin amyloidosis at the time of their carpal tunnel surgery, can still develop a cardiopathy years later. In fact, it is often the case that patients with a history of carpal tunnel treatment are found to have senile systemic amyloidosis 4 or 5 years later. Below is the diagnostic approach for a patient suspected of having cardiac amyloidosis.<\/h6>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-729cbea0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"729cbea0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-35b37e67\" data-id=\"35b37e67\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ce87abf elementor-widget elementor-widget-image\" data-id=\"ce87abf\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" src=\"http:\/\/reseau-amylose.org\/patient\/wp-content\/uploads\/2019\/01\/schemadiag.jpg\" title=\"\" alt=\"\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-15dd8220 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"15dd8220\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6a940057\" data-id=\"6a940057\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-743a3f26 elementor-widget elementor-widget-text-editor\" data-id=\"743a3f26\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>This is the diagnostic strategy for suspected cardiac amyloidosis. The MRI can be carried out if the patient has a pacemaker, but an arrhythmia specialist will have to either switch it off or regulate it and then check it after the examination. Implanting patients with pacemakers which are compatible with MRIs makes it easier to evaluate a cardiopathy in this way.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-7bebdbd8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"7bebdbd8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3d6baaef\" data-id=\"3d6baaef\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-35035ac6 elementor-widget elementor-widget-spacer\" data-id=\"35035ac6\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Type de l&rsquo;Amylose Hereditary TTR Amyloidosis For more than a decade, the treatment for hereditary TTR amyloidosis has been liver transplantation which stops the liver from producing the mutated transthyretin, thereby stabilising the disease\u2019s progression, particularly the neurological effects. In some cases, specialist heart and liver teams will consider doing a double heart-liver transplant. Liver [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1447,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"categories":[],"tags":[],"class_list":["post-1456","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Everything depends on the type of amyloidosis - R\u00e9seau Amylose Site Patient<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/reseau-amylose.org\/jesuispatient\/treating-amyloidosis\/everything-depends-on-the-type-of-amyloidosis\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Everything depends on the type of amyloidosis - R\u00e9seau Amylose Site Patient\" \/>\n<meta property=\"og:description\" content=\"Type de l&rsquo;Amylose Hereditary TTR Amyloidosis For more than a decade, the treatment for hereditary TTR amyloidosis has been liver transplantation which stops the liver from producing the mutated transthyretin, thereby stabilising the disease\u2019s progression, particularly the neurological effects. In some cases, specialist heart and liver teams will consider doing a double heart-liver transplant. 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