Carpal tunnel syndrome, shoulder pain and amyloid deposits in long-term haemodialysis patients.

Carpal Tunnel Syndrome (CTS), and Shoulder Pain and Stiffness (SPS) are common in very long-term haemodialysis patients. To know whether this is a fortuitous association or if there is a link between these two manifestations a retrospective analysis of clinical charts, CTS surgical reports, tendon and synovia biopsies (Congo red, Crystal violet and Thioflavin T) was undertaken for 110 patients treated by haemodialysis (HD) for eight years or more. SPS was less frequent (24%) in 58 patients not operated on for CTS than in 52 operated patients (SPS incidence: 77%). Furthermore the 38 patients with amyloid deposits at carpal biopsy had a very significantly (p less than 0.001) higher incidence of SPS (95%) than the 14 operated patients free of amyloid deposits (SPS incidence: 28%). Hence, amyloid deposits represent a pathological link between these two correlated manifestations in very long-term haemodialysis patients.