Sensitivity of Nerve and Skin Biopsy and Fat Aspirate for Amyloid in Symptomatic Hereditary ATTR Amyloidosis…

Cohort studyNeurology· Jun 2026

Sensitivity of Nerve and Skin Biopsy and Fat Aspirate for Amyloid in Symptomatic Hereditary ATTR Amyloidosis With Peripheral Neuropathy.

Alexa H Panrudkevich, Felipe J S Jones, Kamal Shouman … Marcus V Pinto

DermatopathologyCohort studyDiagnosisQ1IF 3.8

Nerve biopsy detects amyloid more often than fat aspirate or skin biopsy

Sensitivity of Nerve and Skin Biopsy and Fat Aspirate for Amyloid in Symptomatic Hereditary ATTR Amyloidosis With Peripheral Neuropathy.

Alexa H Panrudkevich … Marcus V Pinto

Neurology · Jun 2026

Purpose

The aim of this study was to compare the sensitivity of nerve biopsy, fat aspirate, and skin biopsy in detecting amyloid in symptomatic hereditary transthyretin amyloidosis with peripheral neuropathy (ATTRv-PN).

Methods

With symptomatic PN confirmed by a neurologist or EMG, who underwent an abdominal fat aspiration, skin biopsy, or nerve biopsy, were included.

n = 195 patients

Results

nerve biopsy caught nearly all cases, far more than fat or skin biopsy

48.5%

Fat aspirate

53.1%

Skin biopsy

95%

Nerve biopsy

More results

The median age was 64.2 years (interquartile range 56.9-70.1), and 74.8% were male.

Skin biopsy yielded a higher sensitivity (60% vs 24%; p = 0.02, n = 25) in patients who underwent skin biopsy and fat aspirate.

Skin biopsy was slightly more sensitive than fat aspirate.

“

Conclusion

Nerve biopsies are more accurate than fat aspirates or skin biopsies in identifying patients with hereditary transthyretin amyloidosis.

Sensitivity of Nerve and Skin Biopsy and Fat Aspirate for Amyloid in Symptomatic Hereditary ATTR Amyloidosis With Peripheral Neuropathy.

Sensitivity of Nerve and Skin Biopsy and Fat Aspirate for Amyloid in Symptomatic Hereditary ATTR Amyloidosis With Peripheral Neuropathy.

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