Why the study?
Diagnostic algorithms for amyloidosis have evolved, but key sources of amyloidosis misidentification in the community leading to false positive referrals to specialty centres remained to be identified.
Technetium-pyrophosphate scintigraphy is a major source of false positive referrals for amyloidosis, highlighting the need for careful interpretation and referral to centers of excellence.
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Tc-PYP false positives may drive unnecessary amyloid referrals; leaves open refined diagnostic algorithms in prospective studies.
OBJECTIVE: Diagnostic algorithms for amyloidosis have evolved over the past decade, particularly with the incorporation of imaging-based techniques to detect amyloid cardiomyopathy. We sought to identify the key sources of amyloidosis misidentification in the community, which lead to false positive referrals to a tertiary centre. METHODS: We conducted a retrospective review of all referrals to the Amyloidosis Centre from 2010 to 2021 and identified cases lacking amyloid pathology upon final adjudication after extensive assessment at the centre. Factors for false positive referrals were examined. RESULTS: technetium- pyrophosphate scintigraphy emerged as a major source of false positive referrals. CONCLUSION: Recognising these potential sources of diagnostic error in the workup of amyloidosis can improve patient care. Referral to a centre of excellence for amyloidosis helps confirm an accurate diagnosis and avoid mistreatment.
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Staron et al. (2023) studied this question.
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