Internal Medicine

P1: SBT

0521779407-03 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 19:6

Amyloidosis Amyotrophic Lateral Sclerosis (ALS) 115

Complications & Prognosis

Complications

■progression of disease except following transplantation

Prognosis

■dependent on mutation; survival typically 10–15 years

■improved survival following liver transplant

Beta-2 Microglobulin Amyloid (B2M)

■therapy indicated for all patients with B2M amyloid

■Treatment options

■renal transplantation

Follow-Up

Routine

■assessment of underlying condition as indicated

Complications & Prognosis

Complications

■progression of localized amyloid deposits likely to occur

Prognosis

■deposits regress following renal transplantation

■use of newer dialysis membranes may prevent/reverse this type of

amyloidosis

follow-up

n/a

complications and prognosis

n/a

Amyotrophic Lateral Sclerosis (ALS)......................

MICHAEL J. AMINOFF, MD, DSc

history & physical

■Diffuse weakness, wasting, muscle “flickering”

➣Limb onset in 75%

➣Bulbar onset in 25%

■May be cramps & vague sensory complaints

■No sphincter disturbance

■Family history sometimes present