{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:52:18Z","timestamp":1792479138203,"version":"4.5.0"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das Karpaltunnelsyndrom (KTS) kann ein fr\u00fches klinisches Zeichen einer\n                        systemischen Amyloidose sein. Muskuloskelettale Manifestationen wie KTS,\n                        Tendovaginosis stenosans oder Morbus Dupuytren treten oft Jahre vor\n                        kardialen oder neurologischen Symptomen auf und er\u00f6ffnen damit ein\n                        potenziell relevantes diagnostisches Zeitfenster.<\/jats:p>\n                  <jats:p>Wir f\u00fchrten eine retrospektiv-prospektive Analyse aller Karpaldachspaltungen\n                        (2013\u20132025) durch. F\u00fcr 2013\u20132023 wurden demografische Daten sowie die\n                        Entnahme und Untersuchung von Gewebe erfasst. F\u00fcr 2024 erfolgte retrospektiv\n                        zus\u00e4tzlich eine erneute histologische Nachuntersuchung der Pr\u00e4parate mittels\n                        Kongorot-F\u00e4rbung in polarisiertem Licht. Ab Mai 2025 wurden Biopsien auch im\n                        Rahmen von Ringbandspaltungen und partiellen Aponeurektomien bei Morbus\n                        Dupuytren prospektiv untersucht. Erg\u00e4nzend erfolgte eine narrative\n                        Literatur\u00fcbersicht zur klinischen Bedeutung muskuloskelettaler\n                        Manifestationen bei Amyloidose.<\/jats:p>\n                  <jats:p>Von insgesamt 990 Karpaldachspaltungen erfolgte in 32,4% (n=321) eine\n                        Gewebeentnahme, wovon 25,2% (n=81) histologisch analysiert wurden.\n                        Amyloidablagerungen wurden in 18,8% (n=15) der untersuchten Proben\n                        nachgewiesen. Das mediane Alter der Amyloid-positiven Patienten betrug 82\n                        Jahre, M\u00e4nner waren h\u00e4ufiger betroffen (73%, OR 4,6; p=0,001). Begleitende\n                        muskuloskelettale Erkrankungen traten signifikant h\u00e4ufiger bei\n                        Amyloid-positiven Patienten auf (RR 6,0; p&lt;0,001). Kardiale\n                        Vorerkrankungen fanden sich bei 37,5% der Amyloid-positiven Patienten, davon\n                        zwei mit best\u00e4tigter kardialer Amyloidose. F\u00fcnf Patienten zeigten weder\n                        kardiale noch neurologische Symptome. In Ringbandspaltungen lag die\n                        Amyloid-Nachweisrate bei 15,4%, w\u00e4hrend in Aponeurektomien bei Morbus\n                        Dupuytren bislang kein Nachweis gelang.<\/jats:p>\n                  <jats:p>Unsere Ergebnisse erg\u00e4nzen die Beobachtung, dass Amyloidablagerungen bei\n                        handchirurgischen Eingriffen nachweisbar sein k\u00f6nnen. Die gezielte\n                        histologische Untersuchung synovialer Gewebeproben im Rahmen von\n                        Karpaldachspaltungen oder Ringbandspaltungen kann einen wertvollen Beitrag\n                        zur Fr\u00fcherkennung systemischer Amyloidosen leisten. Angesichts der hohen\n                        Dunkelziffer und der prognostischen Relevanz sollte die Integration einer\n                        risikoadaptierten Biopsiestrategie in handchirurgische Standardverfahren und\n                        Leitlinien gepr\u00fcft werden.<\/jats:p>","DOI":"10.1055\/a-2778-5013","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T22:44:53Z","timestamp":1776206693000},"page":"98-110","source":"Crossref","is-referenced-by-count":1,"title":["Fr\u00fcherkennung systemischer Amyloidosen durch routinem\u00e4\u00dfige\n                    histologische Untersuchung bei Risikopatienten mit Karpaltunneloperation \u2013\n                    narrative Literatur\u00fcbersicht und 12-Jahres-Analyse des eigenen\n                    Patientenkollektivs mit Vorschlag eines Risikobogens"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0963-5726","authenticated-orcid":false,"given":"Irene Mesas","family":"Aranda","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische\n                    Chirurgie, LMU Klinikum, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5954-5695","authenticated-orcid":false,"given":"St\u00e9phanie Kristina","family":"Schwarting","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, Klinikum der Universit\u00e4t M\u00fcnchen,\n                    Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Mieke","family":"Kaas","sequence":"additional","affiliation":[{"name":"Pathologisches Institut, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen\n                    Pathologisches Institut, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-8002","authenticated-orcid":false,"given":"Christoph","family":"R\u00f6cken","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Christian-Albrechts-Universit\u00e4t zu Kiel\n                    Medizinische Fakultat, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casra Sam","family":"Shahidi","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische\n                    Chirurgie, LMU Klinikum, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Mentz","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische\n                    Chirurgie, LMU Klinikum, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Klauschen","sequence":"additional","affiliation":[{"name":"Pathologisches Institut, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen\n                    Pathologisches Institut, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7421-1213","authenticated-orcid":false,"given":"Riccardo","family":"E. Giunta","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische\n                    Chirurgie, LMU Klinikum, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.amjcard.2022.10.057","article-title":"Current Understanding of Systemic Amyloidosis and Underlying Disease\n                    Mechanisms","volume":"185","author":"M M Picken","year":"2022","journal-title":"American Journal of Cardiology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1159\/000545586","article-title":"Light-Chain (AL) Amyloidosis as a Rare Cause of Upper Gastrointestinal Bleeding:\n                    A Case Report and Systematic Literature Review","volume":"18","author":"C M\u00fcller","year":"2025","journal-title":"Case Rep Oncol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1001\/jama.2020.5493","article-title":"Systemic Amyloidosis Recognition, Prognosis, and Therapy: A Systematic\n                    Review","volume":"324","author":"M A Gertz","year":"2020","journal-title":"Jama"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s11864-002-0016-1","article-title":"Primary systemic amyloidosis","volume":"3","author":"M A Gertz","year":"2002","journal-title":"Curr Treat Options Oncol"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/ajh.27177","article-title":"Immunoglobulin light chain amyloidosis: 2024 update on diagnosis, prognosis, and\n                    treatment","volume":"99","author":"M A Gertz","year":"2024","journal-title":"Am J Hematol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1097\/WCO.0000000000000288","article-title":"et al. 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