Familial transthyretin amyloidosis is a slowly progressive condition characterized by the buildup of abnormal deposits of a protein called amyloid (amyloidosis) in the body's organs and tissues. Amyloid deposits in the nerves of the peripheral nervous system result in a loss of sensation in the extremities (peripheral neuropathy). The autonomic nervous system (which controls involuntary body functions such as blood pressure, heart rate, and digestion) as well as the central nervous system (brain and spinal cord) may also be affected. Other areas of the body affected include the heart, kidneys, eyes, and gastrointestinal tract. The age at which symptoms develop varies widely among affected individuals, and may be between ages 20 and 70 years. Mutations in the TTR gene cause the condition. Although it is inherited in an autosomal dominant pattern, not all people who have a TTR gene mutation will develop familial transthyretin amyloidosis.[1]
There are three major forms of familial transthyretin amyloidosis, which are distinguished by their symptoms and the body systems they affect.[1] The neuropathic form of transthyretin amyloidosis primarily affects the peripheral and autonomic nervous systems, resulting in peripheral neuropathy and difficulty controlling bodily functions. The leptomeningeal form of transthyretin amyloidosis primarily affects the central nervous system. The cardiac form of transthyretin amyloidosis affects the heart.[1] To read more about the different forms of familial transthyretin amyloidosis, click here.
The Human Phenotype Ontology (HPO) provides the following list of features that have been reported in people with this condition. Much of the information in the HPO comes from Orphanet, a European rare disease database. If available, the list includes a rough estimate of how common a feature is (its frequency). Frequencies are based on a specific study and may not be representative of all studies. You can use the MedlinePlus Medical Dictionary for definitions of the terms below.
| Signs and Symptoms | Approximate number of patients (when available) |
| Adult onset | - |
| Amyloid deposition in the vitreous humor | - |
| Amyloidosis | - |
| Ataxia | - |
| Autosomal dominant inheritance | - |
| Cardiomegaly | - |
| Cardiomyopathy | - |
| Constipation | - |
| Dementia | - |
| Diarrhea | - |
| Dysarthria | - |
| Dysautonomia | - |
| Headache | - |
| Hearing impairment | - |
| Hemiparesis | - |
| Hyporeflexia | - |
| Impotence | - |
| Increased CSF protein | - |
| Muscle weakness | - |
| Nystagmus | - |
| Orthostatic hypotension due to autonomic dysfunction | - |
| Paraplegia | - |
| Peripheral axonal neuropathy | - |
| Phenotypic variability | - |
| Polyneuropathy | - |
| Progressive | - |
| Seizures | - |
| Spasticity | - |
| Stroke-like episodes | - |
| Tremor | - |
| Urinary incontinence | - |
| Visual impairment | - |
Treatment for familial amyloid polyneuropathy may include:
In terms of preventing some signs and symptoms associated with the condition, orthotopic liver transplantation (OLTX) is reportedly the only effective therapy for the neuropathy associated with familial transthyretin (TTR) amyloidosis. This type of liver transplantation involves replacing the recipient liver with a donor liver. This procedure removes the main production site of the abnormal protein. Successful OLTX results in rapid disappearance of the harmful protein and thus stops the progression of neuropathy. It has been recommended that individuals with the condition considering OLTX be at an age younger than 60 years; have a disease duration less than five years; have either polyneuropathy that is restricted to the lower extremities (legs) or autonomic neuropathy alone; and have no significant cardiac (heart) or renal (kidney) dysfunction. OLTX is reportedly not effective in the non-neuropathic forms of familial transthyretin amyloidosis (i.e., cardiac amyloidosis, leptomeningeal amyloidosis, and familial oculoleptomeningeal amyloidosis). Individuals with leptomeningeal involvement may not be candidates for liver transplantation.[2]
Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.
Nonprofit support and advocacy groups bring together patients, families, medical professionals, and researchers. These groups often raise awareness, provide support, and develop patient-centered information. Many are the driving force behind research for better treatments and possible cures. They can direct people to research, resources, and services. Many groups also have experts who serve as medical advisors. Visit their website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.
Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.
These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.
XIV International Symposium on Amyloidosis
Sunday, April 27, 2014 -
Friday, May 2, 2014
Location:
Indianapolis,
Indiana
Description: One important goal is to foster interactions between investigators who do not meet regularly outside of this event. Through this conference, experts can share unpublished scientific and clinical information about rare diseases that are hard to treat. A second crucial goal is to stimulate interest in a new generation of investigators by providing generous support for at least 10 junior-level researchers to attend the meeting, giving out awards for the most promising clinical research, the best poster, and the best oral presentation by young investigators, and providing childcare options.
Contact: Rebekah S. Rasooly, Ph.D.(301) 594-6007rrl85i@nih.gov
Co-funding Institute(s): National Institute of Diabetes and Digestive and Kidney Diseases, Office of Rare Diseases Research
The following diseases are related to Familial transthyretin amyloidosis. If you have a question about any of these diseases, you can contact GARD.
Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question
I am living in Israel, and my father has the rare disease familial amyloid polyneuropathy. What are the treatment options for this disease? Have people been successfully treated? See answer
