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Lab Med. 2021 Nov 02;52(6):574-577. doi: 10.1093/labmed/lmab022.

Evaluation of Polarized Light and Fluorescence Microscopy of Congo Red Stain in the Diagnosis of Renal Amyloidosis.

Laboratory medicine

Adrian Y S Lee, Angela Bayly, Ming-Wei Lin

Affiliations

  1. ICPMR and NSW Health Pathology, Westmead Hospital, Westmead, NSW, Australia.
  2. Sydney Medical School, The University of Sydney, Westmead, NSW, Australia.

PMID: 33929031 DOI: 10.1093/labmed/lmab022

Abstract

BACKGROUND: Amyloidosis is a devastating multisystemic disease resulting from organ deposition of misfolded proteins and subsequent organ dysfunction. An accurate diagnosis relies frequently on biopsies and microscopy techniques to detect amyloid deposition. We evaluated the diagnostic performance of Congo red staining using polarized light (PM) and fluorescence microscopy (FM) techniques in renal amyloidosis.

METHODS: We performed a retrospective and prospective analysis of all renal biopsies submitted at a large quarternary hospital in Sydney, Australia, that had undergone PM and FM evaluation using Congo red staining. Identification of amyloid fibrils on electron microscopy was considered the reference method.

RESULTS: PM and FM displayed very high sensitivity and specificity in correctly identifying amyloid deposits in renal biopsies that tested positive via Congo red staining. Comparison of the diagnostic statistics revealed that they are diagnostically equivalent.

CONCLUSION: In the diagnosis of renal amyloidosis on biopsy, evaluation of Congo red staining may be reliably performed via PM or FM.

© American Society for Clinical Pathology, 2021. All rights reserved. For permissions, please e-mail: [email protected].

Keywords: Congo red staining; amyloidosis; biopsies; fluorescence; microscopy; polarized microscopy

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