This document provides an overview of amyloidosis, including:
- Amyloidosis is characterized by extracellular deposition of misfolded proteins that form insoluble fibrils, damaging tissues.
- There are different types classified by the misfolded protein involved, including AL, AA, and rare forms.
- Organs commonly affected include the kidney, heart, GI tract, and nerves.
- Diagnosis involves biopsy of affected tissues and staining with Congo red to identify amyloid deposits.
- Prognosis depends on type and organ involvement, with generalized amyloidosis having a poor prognosis of around 2 years.
amyloidosis(including history,physical and chemical properties, classification, variants, staining characteristics, lab diagnosis,morphological patterns according to organ involved ,), basically for undergraduates and residents in pathology
This presentation mainly deals with granuloma formation and various factors involved in it. It describes the examples of granulomatous disorders and gives a details on how to seperate them on histopathology.It also describes type 4 hypersensitivty reaction concisely
amyloidosis(including history,physical and chemical properties, classification, variants, staining characteristics, lab diagnosis,morphological patterns according to organ involved ,), basically for undergraduates and residents in pathology
This presentation mainly deals with granuloma formation and various factors involved in it. It describes the examples of granulomatous disorders and gives a details on how to seperate them on histopathology.It also describes type 4 hypersensitivty reaction concisely
Definition
Morphology and ultra structure
Types of giant cell
Formation of giant cell
Inclusion bodies of giant cell
Giant cell in detail
It’s a mass formed by the union of several distinct cells (usually macrophage).
And usually arise in response to an infection.
Merriam – Webster - Dictionary
Giant cell as an unusually large cell, especially a large multinucleated often phagocytic cell.
A) Cell wall :
Mature giant cell wall is from five to ten times thicker than the cell wall of the surrounding cells
Cell wall has irregular surface with numerous projections jutting into the cytoplasm.
B) Cytoplasm :
Its dense and granular and contain protein
Contain RNA
Traces of carbohydrate and fat.
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Megaloblastic anaemia is a red blood cell disorder due to the inhibition of DNA synthesis during erythropioesis.
Mitotically, the inhibition of the DNA synthesis impaires the progression of the cell cycle development from G2 to (M) stage.
Definition
Morphology and ultra structure
Types of giant cell
Formation of giant cell
Inclusion bodies of giant cell
Giant cell in detail
It’s a mass formed by the union of several distinct cells (usually macrophage).
And usually arise in response to an infection.
Merriam – Webster - Dictionary
Giant cell as an unusually large cell, especially a large multinucleated often phagocytic cell.
A) Cell wall :
Mature giant cell wall is from five to ten times thicker than the cell wall of the surrounding cells
Cell wall has irregular surface with numerous projections jutting into the cytoplasm.
B) Cytoplasm :
Its dense and granular and contain protein
Contain RNA
Traces of carbohydrate and fat.
Aplastic anemia is one of the stem cell disorder which leads to pancytopenia in the peripheral blood and decrease production of all cell line in bone marrow. it require bone marrow transplantation to cure the patient.
Megaloblastic anaemia is a red blood cell disorder due to the inhibition of DNA synthesis during erythropioesis.
Mitotically, the inhibition of the DNA synthesis impaires the progression of the cell cycle development from G2 to (M) stage.
Amyloidosis is a condition associated with a number of inherited and inflammatory disorders in which extracellular deposits of fibrillar proteins are responsible for tissue damange and functional compromise. (Robbins Basic Pathology, 9th Edition)
The following slideshow deals with the classification of Amyloidosis:
A Powerpoint presentation on the epidemiology, etiology, pathogenesis, clinical features, diagnostic work up and treatment of the common types of amyloid.
by post graduates from Maratha Mandal's NathajiRao Halgekar Institute of Dental Sciences, Belgavi.
A step wise presentation of Amylodosis covering,
INTRODUCTION
DEFINITION
HISTORY
PHYSICAL NATURE
CHEMICAL NATURE
CLASSIFICATION
PATHOGENESIS
STAINING CHARACTERISTICS
DIAGNOSTIC TESTS
MORPHOLOGY
CLINICAL FEATURES
TREATMENT
PROGNOSIS
This presentation was made for class 11 & 12 students & was explained in detail during the seminar (SCIEN-CON’ 19).
This approach was taken by the medical students of MIDNAPORE MEDICAL COLLEGE, WEST BENGAL, INDIA for creating awareness about the health & hygiene and self assessment, knowledge & basic management of the most prevalent disease “Dengue”.
This was guided by the our beloved principal sir Dr. Panchanan Kundu & professors of other depts.
The school students (300) were divided in 6 grps & each were subdivided into 5 subgroups before grand lecture & were shown & demonstrated 6 major departments under guidance of medical students.
Seminar was attended by respective schools’ teachers.
Embracing GenAI - A Strategic ImperativePeter Windle
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The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
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A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
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Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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2. TOPICS OF DISCUSSION
Definition
Pathogenesis
Properties of Amyloid
- Physical
- Chemical
Classification
Morphology
Clinical presentation
Diagnosis
3. Amyloidosis - Introduction
Disorder characterized by extracellular
deposition of amyloid (fibrillar proteinaceous
substance)
Amyloid fibril – made of misfolded protein
Amyloid = amylose (starch) like
They have staining characteristic similar to
starch but they are unrelated to starch.
Associated with a number of inherited and
inflammatory disorder
4. Amyloidosis - Definition
Amyloidosis is a disorder characterized by
the extracellular deposits of misfolded
proteins that aggregate to form insoluble
fibrils leads to tissue damage and functional
compromise.
5. Amyloidosis - Pathogenesis
Intracellularly in
proteasomes
Extracellularly by
macrophages
Normally
degraded
Misfolded proteins
Amyloidosis – this normal control mechanism fails
Misfolded protein accumulates outside cells.
6. Amyloidosis - Pathogenesis
Two categories of proteins that form Amyloid
Amyloidosis:
1. Localized: involves single organ
2. Systemic: involves multiple organs or tissues
Effect: tissue damage and compromised function
Normal proteins that have
inherent tendency to misfold
(excessive production)
Mutant proteins that
are prone to
misfolding
7. Amyloid – chemical nature
>20 chemically distinct amyloid exist
Most common forms:
AL (Amyloid light
chain)
AA (Amyloid
associated)
(Aβ) β-amyloid
proteins
• Complete Ig
light chain or
• Amino terminal
fragments of
light chain or
both
• (λ >> κ)
• Non Ig protein
• Synthesized by
liver
• Precursor protein
SAA
• Increased
synthesis in
inflammatory state
• Found in
Alzheimer disease
• Derived from
Amyloid precursor
protein
8. Amyloid - chemical nature
Rare chemical forms:
1. Transthyretin (TTR) - mutant & normal
2. β2-microglobulin (Aβ2m) – long term hemodialysis
3. Misfolded prion proteins
4. Serum amyloid P component – contribute to
amyloid deposition by stabilizing the fibrils and
decreasing their clearance
9. Amyloid – physical nature
Electron
microscopy:
Continuous non-
branching fibril
Diameter –
7.5 – 10 nm
X-ray crystallography &
Infrared spectroscopy
Cross β-pleated sheet
conformation
Common to all amyloid
protein
Responsible for their
distinctive Congo red
staining and birefringence
12. Amyloidosis – classification
1. Primary amyloidosis:
- Plasma cell disorder associated
- AL type amyloid protein
- Ig secreted by clonal plasma cell prone to form
Amyloid (due to its intrinsic physio-chemical
properties)
5 - 15% multiple myeloma cases develop
amyloidosis (not all)
- Amyloidogenic potential of particular chain
depends upon its specific amino acid sequence.
13. Amyloidosis – classification
Contd…
Most of AL amyloid do not have overt
multiple myeloma or clonal B cell neoplasm
- But they are classified as primary
amyloidosis (their presentation is due to amyloid
deposition without any associated disease)
- Modest increase in plasma cell noted in
marrow without any tumor effect
(monoclonal gummopathy)
14. Amyloidosis – classification
2. Reactive systemic amyloidosis:
(also k/a secondary amyloidosis)
- Associated with inflammatory condition
- AA type amyloid protein
- Common association
Rheumatoid arthritis (MC) – 3%, half of them clinically significant
Ankylosing spondylitis
Inflammatory bowel disease
(previously common association – TB, bronchiectasis, chronic
osteomyelitis)
Other cause – Heroine abuse, solid tumors (RCC, HL)
15. Amyloidosis – classification
Reactive systemic amyloidosis:
Inflammation IL6 & IL1 Liver SAA
synthesis ( )
normally degrade
Soluble end products
Monocyte
derived
enzyme
SAA
Genetically derived
mutant SAA
- Resistant to
degradation
Insoluble AA molecule
16. Amyloidosis – classification
3. Heredofamilial Amyloidosis:
Rare & occur in limited geographic area
Familial Mediterranean fever (AR inheritence) – MC
- AA type amyloid protein,
- Related to the recurrent bouts of inflammation.
Familial amyloidotic polyneuropathy –mTTR
4. Hemodialysis associated amyloidosis:
- Patients on long-term hemodialysis
- deposition of β2-microglobulin
- cannot be filtered through dialysis membranes
17. 5. Localized Amyloidosis:
- Involves single organ
- Macroscopically normal or nodular deposits
- Lung, larynx skin, urinary bladder, tongue
- In some cases surrounded by lymphocytes
and plasma cell & AL type amyloid.
18. Amyloidosis – classification
6. Endocrine amyloidosis:
- Microscopic deposits of localized amyloid
found in certain endocrine tumors, such as
- medullary carcinoma of the thyroid gland,
- islet tumors of the pancreas,
- pheochromocytomas, and
- undifferentiated carcinomas of the stomach, and
- in the islets of Langerhans in individuals with type II
diabetes mellitus.
Amyloidogenic proteins seem to be derived either from
- polypeptide hormones (e.g., medullary carcinoma) or
- unique proteins (e.g., islet amyloid polypeptide).
19. Amyloidosis – classification
7. Amyloid of aging
Senile systemic amyloidosis:
- systemic deposition of amyloid
- in elderly patients (usually in their 70s and
80s).
- previously called senile cardiac amyloidosis.
(Because of the dominant involvement and
related dysfunction of the heart)
- The amyloid in this form is composed of the
normal TTR molecule.
20. Amyloidosis –
Organ involvement
No consistent or distinctive pattern of
amyloid deposit
Predominant organ involvement
Primary
amyloidosis
Secondary
amyloidosis
Familial Mediterranean
fever
• Heart
• G I Tract
• Respiratory
organs
• Peripheral
nerves
• Skin
• Tongue
• Kidney
• Liver
• Spleen
• Lymphnodes
• Adrenals
• Thyroid
• Kidney
• Blood vessels
• Spleen
• Respiratory tract
• Liver (rarely)
22. Amyloidosis - Morphology
Microscopic:
- Extracellular
deposit
- Often adjacent to
basement
membrane
- In advanced
stage, encroach,
surrounds and
destroying the
cell
23. Amyloidosis - kidney
Most common and
potentially most serious
form of organ
involvement
Gross – normal or
shrunken [due to ischemia
(vascular narrowing) in
advanced stage]
Microscopy – glomerular
deposit, interstitial,
peritubular, arterial wall
deposit
24. Amyloidosis - spleen
One of two patterns of deposition
is seen.
Sago spleen - deposits are
largely limited to the splenic
follicles, producing tapioca-like
granules grossly.
Lardaceous spleen – amyloid
involves the walls of the splenic
sinuses and connective tissue
framework in the red pulp.
Fusion of the early deposits
gives rise to large, map like
areas of amyloidosis.
25. Amyloidosis –
Clinical manifestation
Amyloidosis may be found as
an unsuspected anatomic change,
having produced no clinical manifestations, or
it may cause death.
The symptoms depend on
the magnitude of the deposits and
on the particular sites or organs affected.
26. Amyloidosis –
Clinical manifestation
Clinical manifestations at first are often entirely
nonspecific, such as –
Weakness,
Weight loss,
Lightheadedness, or
Syncope
Somewhat more specific findings appear later and
most often relate to renal, cardiac, and
gastrointestinal involvement.
27. Amyloidosis - Diagnosis
Histologic demonstration of amyloid deposits in tissues.
The most common sites biopsied are
- The kidney, (when renal manifestations are present), or
- Rectal or gingival tissues
(in patients suspected of having systemic amyloidosis)
Abdominal fat aspirates can also be used for the
diagnosis of systemic amyloidosis. (Congo red stain)
(The test is quite specific, but its sensitivity is low)
Scintigraphy with radiolabelled serum amyloid P
(SAP)
- Rapid and specific test
- Also measures extent of amyloidosis
28. Amyloidosis - Diagnosis
Congo red stain
- Light microscopy –
pink or red color
deposit
- Polarized
microscope – Apple-
green birefringence
EM - Confirmatory
29. Amyloidosis - prognosis
The prognosis for individuals with generalized amyloidosis is poor.
Immunocyte derived amyloidosis (not including multiple myeloma) -
median survival of 2 years after diagnosis.
Persons with myeloma-associated amyloidosis have a poorer prognosis.
Reactive systemic amyloidosis - somewhat better and depends to
some extent on the control of the underlying condition.
New therapeutic strategies aimed at
- Correcting protein misfolding and
- Inhibiting fibrillogenesis are being developed.
