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  • Open Access

Minimal assessment of index cases: the point of view of the neurologist

  • 1
Orphanet Journal of Rare Diseases201510 (Suppl 1) :I11

https://doi.org/10.1186/1750-1172-10-S1-I11

  • Published:

Keywords

  • Neuropathy
  • Cardiomyopathy
  • Clinical Examination
  • Genetic Testing
  • Nerve Conduction

The first and most important step is to consider TTR-FAP as a diagnosis upon thorough patient history and clinical examination. The further diagnostic process includes the following assessments: clinical examination for polyneuropathic and autonomic signs including temperature and pain sensitivity in the feet. In addition, nerve conduction studies are essential to document large fiber neuropathy. Further on, the patient should be checked for signs of cardiomyopathy and cardiac conduction disorders, since cardiac disease is common in TTR-FAP. Although there will be a characteristic pattern of findings with these examninations, they cannot prove the diagnosis of TTR-FAP. Further investigations include histopathology with demonstration of amyloid by Congo red staining, immunhistochemistry to show that amyloid is composed of TTR, and genetic testing to reveal the specific mutation underlying the disorder.

Authors’ Affiliations

(1)
University Heidelberg, Heidelberg, Germany

Copyright

© Hund 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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