AMYLOIDOSIS AS A CAUSE OF CARPAL TUNNEL SYNDROME IN HAEMODIALYSIS PATIENTS

Over a five-year period (1981-1983, nine patients on haemodialysis developed carpal tunnel syndrome. Five patients, following biopsy of synovium in the carpal tunnel or biopsy of thickened epineurium of the median nerve, were found to have amyloid deposits in the soft tissues. The relationship between this condition, dialysis arthropathy and long-term haemodialysis is reviewed. In addition, in this small group of patients no relationship to the side of the fistula has been demonstrated and two patients developed recurrent problems despite initial open decompression of the carpal tunnel. Carpal tunnel syndrome was first described in a haemodialysis patient by Warren and Otieno (1975) and the incidence of this condition varies greatly between haemodialysis units from 2 % to 3 1%. Increasing interest in the condition has occurred because a specific type of amyloid deposit has recently been found in the synovium of the carpal tunnel (Vandenbroucke et al., 1986). In addition, many surgeons have noted that the incidenc