{"id":3548,"date":"2021-04-14T12:06:25","date_gmt":"2021-04-14T12:06:25","guid":{"rendered":"https:\/\/www.reseau-amylose.org\/jesuissoignant\/?page_id=3548"},"modified":"2024-02-14T11:28:01","modified_gmt":"2024-02-14T10:28:01","slug":"examens-complementaires-electrocardiogramme-le-bilan-biologique-de-l-amylose","status":"publish","type":"page","link":"https:\/\/reseau-amylose.org\/jesuissoignant\/examens-complementaires-electrocardiogramme-le-bilan-biologique-de-l-amylose\/","title":{"rendered":"Le bilan biologique de l’amylose"},"content":{"rendered":"\t\t
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Le bilan biologique de l'amylose<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Examens compl\u00e9mentaires<\/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
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Les examens compl\u00e9mentaires cardiaques permettent de suspecter l\u2019amylose. Seul le diagnostic anatomopathologique permet de l\u2019affirmer. L\u2019\u00e9chocardiographie, l\u2019IRM et la scintigraphie sont compl\u00e9mentaires dans l\u2019approche diagnostic toutefois ces examens ne permettent pas de distinguer avec certitude les diff\u00e9rentes formes d\u2019amylose [ Pr\u00e9sentation clinique des amyloses cardiaques]<\/a><\/p>

\u00a0<\/p>

Le bilan biologique de l’amylose est important et participe au typage de l’amylose.<\/p>\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

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Biomarqueurs cardiaques dans le bilan biologique de l'amylose<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Les peptides natriur\u00e9tiques sont fr\u00e9quemment augment\u00e9s dans les formes s\u00e9v\u00e8res de cardiopathie amylo\u00efdes (Damy T et al, Amyloid 2016<\/a> <\/em>). La troponine I et T sont fr\u00e9quemment augment\u00e9es dans la CA en l\u2019absence de coronaropathie. L\u2019\u00e9l\u00e9vation de ces marqueurs t\u00e9moigne de la souffrance des cardiomyocytes du fait de l\u2019infiltration myocardique. L\u2019\u00e9l\u00e9vation de la troponine ainsi que des pseudo-ondes Q \u00e0 l\u2019ECG conduit fr\u00e9quemment \u00e0 r\u00e9alisation de coronarographie chez ces patients. Une coronographie normale dans ce contexte doit faire r\u00e9aliser une \u00e9chocardiographie \u00e0 la recherche d\u2019un \u00e9paississement myocardique. L\u2019\u00e9l\u00e9vation des marqueurs a permis d\u2019\u00e9tablir un score de gravit\u00e9 dans les amyloses AL (Mayo Clinic) qui d\u00e9finit le protocole de chimioth\u00e9rapie et permet le suivi des patients. La diminution des marqueurs traduit la r\u00e9ponse \u00e0 la chimioth\u00e9rapie et est un facteur de bon pronostic. Des scores utilisant soit le NTproBNP et la troponine<\/a> ou soit le\u00a0NTproBNP et la fonction r\u00e9nale<\/a>\u00a0permettent \u00e9galement de pr\u00e9dire le pronostic dans les amyloses \u00e0 transthyr\u00e9tine.<\/p>\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

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Rechercher une gammapathie : le bilan biologique de l'amylose<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Le diagnostic des amyloses AL n\u00e9cessite la r\u00e9alisation d\u2019\u00e9lectrophor\u00e8se des protides, de l\u2019immunofixation, du dosage des cha\u00eenes libres s\u00e9riques et de la recherche de prot\u00e9inurie de Bence Jones. Le bilan biologique identifie le pic monoclonal et permettent de quantifier les cha\u00eenes kappa et lambda. L\u2019analyse du g\u00e8ne de la transthyr\u00e9tine par s\u00e9quen\u00e7age est n\u00e9cessaire pour \u00e9tablir le diagnostic d\u2019amylose h\u00e9r\u00e9ditaire \u00e0 transthyr\u00e9tine .<\/p>\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

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Comment rechercher une gammapathie quand on suspecte une amylose<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Val\u00e9rie MOLINIER-FRENKEL<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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<\/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
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Comment faire le diagnostic pr\u00e9coce des amyloses AL ?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Olivier DECAUX<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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<\/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
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Pourquoi r\u00e9aliser des tests de gammapathie syst\u00e9matiquement en cas de suspicion d'amylose ?<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Val\u00e9rie MOLINIER-FRENKEL<\/h4>\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
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<\/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
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A qui faire un test g\u00e9n\u00e9tique ?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Le bilan biologique de l’amylose aide au typage de l’amylose. Un test g\u00e9n\u00e9tique doit \u00eatre fait pour tous les patients avec une amylose ATTR.\u00a0<\/span><\/p>\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

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<\/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
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Pour en savoir plus sur le bilan g\u00e9n\u00e9tique<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tCliquez ici<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\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<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Le bilan biologique de l’amylose Examens compl\u00e9mentaires Les examens compl\u00e9mentaires cardiaques permettent de suspecter l\u2019amylose. Seul le diagnostic anatomopathologique permet de l\u2019affirmer. L\u2019\u00e9chocardiographie, l\u2019IRM et la scintigraphie sont compl\u00e9mentaires dans l\u2019approche diagnostic toutefois ces examens ne permettent pas de distinguer avec certitude les diff\u00e9rentes formes d\u2019amylose [ Pr\u00e9sentation clinique des amyloses cardiaques] \u00a0 Le bilan […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[],"tags":[],"class_list":["post-3548","page","type-page","status-publish","hentry"],"yoast_head":"\nLe bilan biologique de l'amylose - R\u00e9seau Amylose<\/title>\n<meta name=\"description\" content=\"Le bilan biologique de l'amylose : biomarqueurs cardiaques, peptides natriur\u00e9tiques - la recherche de gammapathies et le test g\u00e9n\u00e9tique\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/reseau-amylose.org\/jesuissoignant\/examens-complementaires-electrocardiogramme-le-bilan-biologique-de-l-amylose\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Le bilan biologique de l'amylose - 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