Systemic Wild-type Amyloid Transthyretin Amyloidosis in Carpal Tunnel Syndrome in Men

Carpal tunnel syndrome is the most common initial manifestation of systemic wild-type amyloid transthyretin (ATTR) amyloidosis, a systemic and lethal form of amyloidosis, which can alternatively present as a focal disease. Herein, we present a case series of six men who underwent the removal of a portion of the transverse carpal ligament during carpal tunnel release surgery and were diagnosed with ATTR amyloidosis among a cohort of 38 cases. In addition, one of the six patients with ATTR amyloidosis had cardiac and gastric amyloidosis. Extraction of part of a ligament during carpal tunnel release surgery is a straightforward procedure that can help diagnose ATTR amyloidosis at an early stage using a simple approach. Considering the epidemiology of carpal tunnel syndrome and systemic wild-type ATTR amyloidosis, amyloidosis can be ruled out during carpal tunnel release surgery at least for men.