Electron-Microscopic and Inimunohistochemical Study of Beta-2-Microglobulin-Related Amyloidosis

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Abstract
β2-Microglobulin (β2-MG)-related amyloidosis has been reported as a complication in long-term hemodialysis patients. We observed β2-MG amyloid deposits in synovial sheaths, bone cysts and gastric mucosa. They showed unique ultrastructural features, that is bundles or nodules consisting of curved or linear amyloid fibrils, associated with various cell reactions. The electron-microscopic histochemical study showed that they strongly stained with periodic acid-silver methenamine stain. A similar phenomenon was noticed in the spicules or bundles of amyloid fibrils in primary and secondary renal amyloidosis. With the cationic reagent toluidine blue 0, proteoglycanlike structures were observed around amyloid bundles and nodules, but not on each fibrils. Based on these results, we postulate that there is a close relationship between ultrastructural features and histochemical characteristics in β2-MG amyloid fibrils.