This article reports a prospective 1-year study of peripheral nerve involvement in wild-type transthyretin amyloidosis (ATTRwt) cardiomyopathy.
Key findings from the provided abstract:
23 patients with ATTRwt were compared with healthy controls.
Small-fiber loss was common: abnormal intra-epidermal nerve fiber density occurred in 47.8% of patients vs. 4.3% of controls (p = 0.002).
Quantitative sensory testing was abnormal for nearly all measures except cold detection.
Sensory-predominant axonal polyneuropathy was identified in 82.6% of patients.
Greater neurological impairment was associated with higher symptom burden and fatigue.
The study used a multimodal evaluation including:
Neuropathy Impairment Score–Lower Limb
Nerve conduction studies
Quantitative sensory testing
Serum neurofilament light chain
Skin-biopsy assessment of intra-epidermal nerve fiber density
Norfolk QoL-DN and Chalder Fatigue scales
Overall implication: Peripheral nerve involvement—particularly sensory and small-fiber neuropathy—may be substantially more frequent in ATTRwt than traditionally recognized, even when cardiomyopathy is the dominant clinical presentation.
Tags: intra-epidermal nerve fiber density in ATTRmultimodal nerve assessment in amyloidosisnerve conduction studies in ATTRwtneurofilament light chain as biomarker in amyloidosisneuropathy burden in transtperipheral nerve involvement in amyloidosisquantitative sensory testing in amyloidosissensory-predominant axonal polyneuropathyskin biopsy for nerve fiber assessmentsmall-fiber neuropathy in ATTRwtwild-type transthyretin amyloidosis
