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CLINICAL DIAGNOSIS OF AMYLOIDOSIS

JAMA. 1963;183(13):1104. doi:10.1001/jama.1963.03700130072014.
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Antemortem diagnosis of amyloidosis has been hampered by the absence of simple and reliable clinical tests. When the intravenous Congo red test was introduced in 1923, disappearance of 60% of the dye in the blood after one hour was considered suggestive for the presence of amyloidosis. Since then the minimum percentage of dye recovery required for a positive test has risen to 80% or 90%. Even with these criteria, there is a high incidence of false negatives. A small number of false positive responses to the Congo red test also has been reported. If early diagnoses are to be made more frequently, it is apparent that other techniques are necessary. Gingival biopsy undoubtedly gives fewer false negative results, but this test is often distressing to the patient. Liver biopsies present the danger of uncontrollable hemorrhage. To obviate these hazards and discomforts, Gafni and Sohar1 utilized rectal mucosa biopsy. The

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