Prevalence of ATTR amyloid in the carpal tunnel

• Research type

  Research Study

• Full title

  A study of the prevalence of transthyretin amyloid deposition in individuals with symptomatic carpal tunnel syndrome

• IRAS ID

  181075

• Contact name

  Philip Hawkins

• Contact email

  p.hawkins@ucl.ac.uk

• Sponsor organisation

  Royal Free London NHS Foundation Trust

• Duration of Study in the UK

  3 years, 0 months, 1 days

• Research summary

  CCarpal Tunnel Syndrome (CTS), is caused by compression of the median nerve in the wrist. CTS affects 3-5 in 100
  people in the UK, making it a common nerve problem. It results in pain and weakness in the hands, in severe cases
  the ligaments compressing the nerve are cut to relieve the pressure, in a simple and curative surgical procedure. The
  cause of the compression is often not explored in the UK, whilst in other countries studies have shown that abnormal
  protein deposits called transthyretin (TTR) amyloid deposits are the cause in up to 30% of cases. TTR amyloid
  deposits may also be found in the heart, causing a serious disease called ATTR cardiac amyloidosis – this results in
  heart failure and is mainly found in the elderly. It is not an easy disease to diagnose and many sufferers go
  undiagnosed for several years, the diagnosis often being made at later stages of the disease when treatment is
  unlikely to be as effective. Interestingly, many patients presenting with ATTR cardiac amyloidosis report having CTS in
  the past, often extending back 10 years or more. However, the proportion of patients with CTS caused by ATTR amyloid
  deposits who go on to develop the cardiac disease is not known. The aim of the study is to determine how frequently
  CTS is caused by ATTR amyloid deposits by looking for the presence of ATTR amyloid in small tissue samples taken
  at the time of carpal tunnel decompression surgery. Those having these deposits will be offered long term follow up in
  order to aid early detection of the cardiac disease, should it occur. Persons with CTS, referred for surgery to Mr
  Goddard (orthopaedic surgeon) will be given the study information sheet in his clinic, and this will be followed up by a
  telephone call to discuss and answer questions. Mr Goddard will obtain consent before surgery; a small tissue
  sample will be taken and sent to the laboratory for analysis.

• REC name

  London - Central Research Ethics Committee

• REC reference

  17/LO/0176

• Date of REC Opinion

  10 Apr 2017

• REC opinion

  Further Information Favourable Opinion