arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2010-16-1-88-92arthyper-1521Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESЛокальный амилоидоз в ротовой полости у больных воспалительными заболеваниями пародонта и хронической сердечной недостаточностьюLocal amyloidosis of the oral cavity in patients with inflammatory periodontal disease and chronic heart failureБармашеваА.BarmashevaA. A.barmashinka@mail.ruСемернинЕ. Н.SemerninE. N.noemail@neicon.ruКузнецоваИ. А.KuznetsovaI. A.noemail@neicon.ruШиршоваН. А.ShirshovaN. A.noemail@neicon.ruРыбаковаМ. Г.RybakovaM. G.noemail@neicon.ruШляхтоЕ. В.ShlyakhtoE. V.noemail@neicon.ruОреховаЛ. Ю.OrekhovaL. U.noemail@neicon.ruГудковаА. Я.GudkovaA. Y.noemail@neicon.ruФГУ «Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова Росмедтехнологий» ГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова»РоссияAlmazov Federal Heart, Blood and Endocrinology Centre Pavlov State Medical UniversityRussian FederationГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова»РоссияPavlov State Medical UniversityRussian FederationФГУ «Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова Росмедтехнологий» ГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. академика И.П. Павло- ва»РоссияAlmazov Federal Heart, Blood and Endocrinology Centre Pavlov State Medical UniversityRussian FederationГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. академика И.П. Павло- ва»РоссияPavlov State Medical UniversityRussian FederationФГУ «Федеральный Центр сердца, крови и эндокринологии им. В.А. Алмазова Росмедтехнологий» ГОУ ВПО «Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова»РоссияPavlov State Medical UniversityRussian Federation2010280220101618892Copyright © Бармашева А.A., Семернин Е.Н., Кузнецова И.А., Ширшова Н.А., Рыбакова М.Г., Шляхто Е.В., Орехова Л.Ю., Гудкова А.Я., 20102010Бармашева А., Семернин Е.Н., Кузнецова И.А., Ширшова Н.А., Рыбакова М.Г., Шляхто Е.В., Орехова Л.Ю., Гудкова А.Я.Barmasheva A.A., Semernin E.N., Kuznetsova I.A., Shirshova N.A., Rybakova M.G., Shlyakhto E.V., Orekhova L.U., Gudkova A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1521

Актуальность. Наиболее признанным стандартом диагностики амилоидоза является биопсия тканей, в том числе биопсия тканей ротовой полости. В полости рта может проявляться как системный, так и локальный амилоидоз. Для гистологического исследования предлагается забирать участки слизистой оболочки щеки, десны, языка и губы. Материалы и методы. У 32 больных хронической сердечной недостаточностью (ХСН) I-IV функционального класса с подозрением на системный амилоидоз проведено гистологическое исследование биопсии слизистой оболочки щеки и десны, с окраской гематоксилином и эозином, конго красным, были выполнены иммуногистохимические реакции с антителами ƒ и ƒ (фирмы DAKO), также материал изучали в поляризованном свете. Результаты. Конго-поло- жительная реакция выявлена в 71,9 % случаев, однако системный AL-амилоидоз (подтвержденный на основании дисбаланса ƒ: ƒ) и наследственная форма амилоидоза с преимущественным поражением кожи подтверждены только в трех случаях (9,4 %). При стоматологическом обследовании больных ХСН с конго-положительной реакцией была выявлена высокая распространенность хронического генерализованного пародонтита тяжелой степени тяжести (37,5 %). Выводы. Распространенный хронический воспалительный процесс в тканях пародонта может служить причиной локального отложения амилоидного белка в полости рта.

Background. Systemic and local amyloidosis can be evident in the oral cavity. Biopsy including oral mucosa biopsy is a standard of amyloidosis diagnosis. Oral mucosa species of the cheek, gingiva, tongue and lip were admitted for the histological investigation. Material and methods. Cheek and gingival biopsies of 32 patients with I-IV NYHA functional class of chronic heart failure (CHF) and suspected systemic amyloidosis were investigated histologically with heama toxylin-eosin and Congo red staining and immunohistochemical analysis to ƒ and ƒ antibodies (DAKO) and following investigation in the polar light. Results. Positive reaction was observed in 71,9 % cases, while systemic AL-amyloidosis (confi rmed by ƒ:ƒ disbalance) and genetic form of the amyloidosis with predominantly skin disease were diagnosed only in 3 cases (9,4 %). Dental investigation of the patients with CHF and congo-positive reaction determined high prevalence of the severe generalised periodontitis (37,5 %). Conclusion. Chronic generalized infl ammation of the periodontium may be the cause of the local amyloid deposition in the oral cavity.

амилоидозхроническая сердечная недостаточностьбиопсия тканей ротовой полостиге- нерализованный пародонтитReferencesKolokotronis A., Louloudiadis K., Fotiou G., Matiais A. Oral manifestations of amyloidosis: report of two cases // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. - 2004. - Vol. 98, № 2. - P. 2000-2001.Kolokotronis A., Louloudiadis K., Fotiou G., Matiais A. Oral manifestations of amyloidosis: report of two cases // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. - 2004. - Vol. 98, № 2. - P. 2000-2001.Kyle R.A., Greipp P.R. Amyloidosis (AL). Clinical and laboratory features in 229 cases // Mayo Clin. Proc. - 1983. - Vol. 58, № 10. - P. 665-683.Kyle R.A., Greipp P.R. Amyloidosis (AL). Clinical and laboratory features in 229 cases // Mayo Clin. Proc. - 1983. - Vol. 58, № 10. - P. 665-683.Schwartz H.C., Olson D.J. Amyloidosis: a rational approach to diagnosis by intraoral biopsy // Oral Surg. Oral Med. Oral Pathol. - 1975. - Vol. 39, № 6. - P. 837-843.Schwartz H.C., Olson D.J. Amyloidosis: a rational approach to diagnosis by intraoral biopsy // Oral Surg. Oral Med. Oral Pathol. - 1975. - Vol. 39, № 6. - P. 837-843.Singhi M.K., Gupta L.K., Kachhawa D. Sclerodermoid hands with waxy papules on face // Indian J. Dermatol. Venereol. Leprol. - 2004. - Vol. 70, № 4. - P. 263-265.Singhi M.K., Gupta L.K., Kachhawa D. Sclerodermoid hands with waxy papules on face // Indian J. Dermatol. Venereol. Leprol. - 2004. - Vol. 70, № 4. - P. 263-265.Goltz R.W. Systematized amyloidosis // Medicine (Baltimore). - 1952. - Vol. 31, № 4. - P. 381-409.Goltz R.W. Systematized amyloidosis // Medicine (Baltimore). - 1952. - Vol. 31, № 4. - P. 381-409.Keith D.A. Oral features of primary amyloidosis // Br. J. Oral Surg. - 1972. - Vol. 10, № 2. - P. 107-115.Keith D.A. Oral features of primary amyloidosis // Br. J. Oral Surg. - 1972. - Vol. 10, № 2. - P. 107-115.McCarty P.L., Shklar G. Diseases of the oral mucosa. - NY: The Blakiston Company, 1964. - P. 250-251.McCarty P.L., Shklar G. Diseases of the oral mucosa. - NY: The Blakiston Company, 1964. - P. 250-251.Ware W.H., Silverman S. Primary amyloid disease: review of the literature and report of a case // J. Oral Surg. Anesth. Hosp. Dent. Serv. - 1961. - Vol. 19. - P. 140-145.Ware W.H., Silverman S. Primary amyloid disease: review of the literature and report of a case // J. Oral Surg. Anesth. Hosp. Dent. Serv. - 1961. - Vol. 19. - P. 140-145.Hurley H.J., Weinberg R. Induced intralesional hemorrhage in primary systemic amyloidosis // Arch. Dermatol. - 1964. - Vol. 89. - P. 678-681.Hurley H.J., Weinberg R. Induced intralesional hemorrhage in primary systemic amyloidosis // Arch. Dermatol. - 1964. - Vol. 89. - P. 678-681.Kyle R.A., Bayrd E.D. Amyloidosis: review of 236 cases // Medicine (Baltimore). - 1975. - Vol. 54, № 4. - P. 271-299.Kyle R.A., Bayrd E.D. Amyloidosis: review of 236 cases // Medicine (Baltimore). - 1975. - Vol. 54, № 4. - P. 271-299.Kerner M.M., Wang M.B., Angier G. et al. Amyloidosis of the head and neck. A clinicopathologic study of the UCLA experience, 1955-1991 // Arch. Otolaryngol. Head Neck. Surg. - 1995. - Vol. 121, № 7. - P. 778-782.Kerner M.M., Wang M.B., Angier G. et al. Amyloidosis of the head and neck. A clinicopathologic study of the UCLA experience, 1955-1991 // Arch. Otolaryngol. Head Neck. Surg. - 1995. - Vol. 121, № 7. - P. 778-782.Gertz M.A., Kyle R.A. Primary systemic amyloidosis - a diagnostic primer // Mayo Clin. Proc. - 1989. - Vol. 64, № 12. - P. 1505- 1519.Gertz M.A., Kyle R.A. Primary systemic amyloidosis - a diagnostic primer // Mayo Clin. Proc. - 1989. - Vol. 64, № 12. - P. 1505- 1519.Franklin E.L. Gorevic P.D. The amyloid disease. - London: Academic Press, 1980. - P. 1219-1230.Franklin E.L. Gorevic P.D. The amyloid disease. - London: Academic Press, 1980. - P. 1219-1230.Salisbury P.L., Jacoway J.R. Oral amyloidosis: a late complication of multiple myeloma // Oral Surg. Oral Med. Oral Pathol. - 1983. - Vol. 56, № 1. - P. 48-50.Salisbury P.L., Jacoway J.R. Oral amyloidosis: a late complication of multiple myeloma // Oral Surg. Oral Med. Oral Pathol. - 1983. - Vol. 56, № 1. - P. 48-50.Raubenheimer E.J., Dauth J., Pretorius F.J. Multiple myeloma and amyloidosis of the tongue // J. Oral Pathol. - 1988. - Vol. 17, № 9-10. - P. 554-559.Raubenheimer E.J., Dauth J., Pretorius F.J. Multiple myeloma and amyloidosis of the tongue // J. Oral Pathol. - 1988. - Vol. 17, № 9-10. - P. 554-559.Reinish E.I., Raviv M., Srolovitz H., Gornitsky M. Tongue, primary amyloidosis, and multiple myeloma // Oral Surg. Oral Med. Oral Pathol. - 1994. - Vol. 77, № 2. - P. 121-125.Reinish E.I., Raviv M., Srolovitz H., Gornitsky M. Tongue, primary amyloidosis, and multiple myeloma // Oral Surg. Oral Med. Oral Pathol. - 1994. - Vol. 77, № 2. - P. 121-125.Raubenheimer E.J., Dauth J., de Coning J.P. Multiple myeloma presenting with extensive oral and perioral amyloidosis // Oral Surg. Oral Med. Oral Pathol. - 1986. - Vol. 61, № 5. - P. 492-497.Raubenheimer E.J., Dauth J., de Coning J.P. Multiple myeloma presenting with extensive oral and perioral amyloidosis // Oral Surg. Oral Med. Oral Pathol. - 1986. - Vol. 61, № 5. - P. 492-497.Kolokotronis A., Chatzigiannis I., Paloukidou N. Oral involvement in a case of AA amyloidosis // Oral Diseases. - 2003. - Vol. 9, № 5. - P. 269-272.Kolokotronis A., Chatzigiannis I., Paloukidou N. Oral involvement in a case of AA amyloidosis // Oral Diseases. - 2003. - Vol. 9, № 5. - P. 269-272.Xavier S.D., Bussoloti I.F., Muller H. Macroglossia secondary to systemic amyloidosis: case report and literature review // Ear. NoseXavier S.D., Bussoloti I.F., Muller H. Macroglossia secondary to systemic amyloidosis: case report and literature review // Ear. NoseThroat J. - 2005. - Vol. 84, № 6. - P. 358-361.Throat J. - 2005. - Vol. 84, № 6. - P. 358-361.Khoury S., Dusek J.J., Anderson G.B., Vigneswaran N. Systemic amyloidosis manifesting as localized, severe periodontitis // J. Am. Dent. Assoc. - 2004. - Vol. 135, № 5. - P. 617-623.Khoury S., Dusek J.J., Anderson G.B., Vigneswaran N. Systemic amyloidosis manifesting as localized, severe periodontitis // J. Am. Dent. Assoc. - 2004. - Vol. 135, № 5. - P. 617-623.Souza P., Sawh R.N. A 54 year-old man with bilateral enlargement of submandibular glands and proteinuria. - Department of pathology, University of Oklahoma Health Sciences Center. - April 2006, Case 604-2. - [Электронный ресурс]. - Режим доступа: URL:http://moon. ouhsc.edu/kfung/jty1/Com06/Com604-2-Diss.htmSouza P., Sawh R.N. A 54 year-old man with bilateral enlargement of submandibular glands and proteinuria. - Department of pathology, University of Oklahoma Health Sciences Center. - April 2006, Case 604-2. - [Электронный ресурс]. - Режим доступа: URL:http://moon. ouhsc.edu/kfung/jty1/Com06/Com604-2-Diss.htmKoren R., Veltman V., Halpern M. et al. Localized amyloid tumor of the tongue. A case report and review of the literature // Rom. J. Morphol. Embryol. - 1998. - Vol. 44, № 1-4. - P. 179-182.Koren R., Veltman V., Halpern M. et al. Localized amyloid tumor of the tongue. A case report and review of the literature // Rom. J. Morphol. Embryol. - 1998. - Vol. 44, № 1-4. - P. 179-182.Takeda Y., Sekiyama S., Suzuki A., Hirose H. Localized oral amyloidosis: ultrastructural and immunohistochemical study // J. Oral Pathol. - 1987. - Vol. 16, № 5. - P. 278-281.Takeda Y., Sekiyama S., Suzuki A., Hirose H. Localized oral amyloidosis: ultrastructural and immunohistochemical study // J. Oral Pathol. - 1987. - Vol. 16, № 5. - P. 278-281.Timosca G., Gavrilita L.A. Primary localized amyloidosis of the palate // Oral Surg. Oral Med. Oral Pathol. - 1977. - Vol. 44, № 1. - P. 76-83.Timosca G., Gavrilita L.A. Primary localized amyloidosis of the palate // Oral Surg. Oral Med. Oral Pathol. - 1977. - Vol. 44, № 1. - P. 76-83.Falk R.H., Comenzo R.L., Skinner M. The systemic amyloidoses //N. Engl. J. Med. - 1997. - Vol. 337, № 13. - P. 898-909.Falk R.H., Comenzo R.L., Skinner M. The systemic amyloidoses //N. Engl. J. Med. - 1997. - Vol. 337, № 13. - P. 898-909.Gertz M.A., Kyle R.A., Thibodeau S.N. Familial amyloidosis: a study of 52 North American-born patients examined during a 30-year period // Mayo Clin. Proc. - 1992. - Vol. 67, № 5. - P. 428-440.Gertz M.A., Kyle R.A., Thibodeau S.N. Familial amyloidosis: a study of 52 North American-born patients examined during a 30-year period // Mayo Clin. Proc. - 1992. - Vol. 67, № 5. - P. 428-440.Gertz M.A., Rajkumar S.V. Primary systemic amyloidosis // Curr. Treat. Options Oncol. - 2002. - Vol. 3, № 3. - P. 261-271.Gertz M.A., Rajkumar S.V. Primary systemic amyloidosis // Curr. Treat. Options Oncol. - 2002. - Vol. 3, № 3. - P. 261-271.Glenner G.G. Amyloid deposits and amyloidosis. The betafi brilloses (fi rst of two parts) // N. Engl. J. Med. - 1980. - Vol. 302, № 23. - P. 1283-1292.Glenner G.G. Amyloid deposits and amyloidosis. The betafi brilloses (fi rst of two parts) // N. Engl. J. Med. - 1980. - Vol. 302, № 23. - P. 1283-1292.Khan M.F., Falk R.H. Amyloidosis // Postgrad. Med. J. - 2001. - Vol. 77, № 913. - P. 686-693.Khan M.F., Falk R.H. Amyloidosis // Postgrad. Med. J. - 2001. - Vol. 77, № 913. - P. 686-693.Moorhead J.G. Head and neck manifestations of amyloidosis. - 1992, April 9. - [Электронный ресурс]. - Режим доступа: URL: http://www.bcm.edu/oto/grand/4992.htmlStoopler E.T., Sollecito T.P., Chen S.Y. Amyloid deposition in the oral cavity: a retrospective study and review of the literature // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. - 2003. - Vol. 95, № 6. - P. 674-680.Moorhead J.G. Head and neck manifestations of amyloidosis. - 1992, April 9. - [Электронный ресурс]. - Режим доступа: URL: http://www.bcm.edu/oto/grand/4992.htmlStoopler E.T., Sollecito T.P., Chen S.Y. Amyloid deposition in the oral cavity: a retrospective study and review of the literature // Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. - 2003. - Vol. 95, № 6. - P. 674-680.Selikoff I.J., Robitzek E.H. Gingiva biopsy for the diagnosis of generalized amyloidosis // Am. J. Path. - 1947. - Vol. 23. - P. 1099-1111.Selikoff I.J., Robitzek E.H. Gingiva biopsy for the diagnosis of generalized amyloidosis // Am. J. Path. - 1947. - Vol. 23. - P. 1099-1111.Gorlin R., Gottsegen R. The role of the gingival biopsy in secondary amyloid disease // Oral Surg. Oral Med. Oral Pathol. - 1949. - Vol. 2, № 7. - P. 864-866.Gorlin R., Gottsegen R. The role of the gingival biopsy in secondary amyloid disease // Oral Surg. Oral Med. Oral Pathol. - 1949. - Vol. 2, № 7. - P. 864-866.Lighterman I. A modifi ed technique for gingival biopsy in the diagnosis of secondary amyloidosis // Oral Surg. Oral Med. Oral Pathol. - 1951. - Vol. 4, № 3. - P. 351-354.Lighterman I. A modifi ed technique for gingival biopsy in the diagnosis of secondary amyloidosis // Oral Surg. Oral Med. Oral Pathol. - 1951. - Vol. 4, № 3. - P. 351-354.Tieger N., Cochen A.S., Calkins E. Gingival biopsy as a diagnostic aid in amyloid disease // Arch. Oral Biol. - 1960. - Vol. 1. - P. 187- 192.Tieger N., Cochen A.S., Calkins E. Gingival biopsy as a diagnostic aid in amyloid disease // Arch. Oral Biol. - 1960. - Vol. 1. - P. 187- 192.Calkins E., Cohen A.S. Diagnosis of amyloidosis // Bull. Rheum. Dis. - 1960. - Vol. 10. - P. 215-218.Calkins E., Cohen A.S. Diagnosis of amyloidosis // Bull. Rheum. Dis. - 1960. - Vol. 10. - P. 215-218.Meyer I. The value of gingival biopsy in the diagnosis of generalized amyloidosis // J. Oral Surg. (Chic). - 1950. - Vol. 8, № 4. - P. 314-323.Meyer I. The value of gingival biopsy in the diagnosis of generalized amyloidosis // J. Oral Surg. (Chic). - 1950. - Vol. 8, № 4. - P. 314-323.Van der Waal I., Fehmers M.C., Kraal E.R. Amyloidosis: its signifi cance in oral surgery. Review of the literature and report of a case // Oral Surg. Oral Med. Oral Pathol. - 1973. - Vol. 36, № 4. - P. 469-481.Van der Waal I., Fehmers M.C., Kraal E.R. Amyloidosis: its signifi cance in oral surgery. Review of the literature and report of a case // Oral Surg. Oral Med. Oral Pathol. - 1973. - Vol. 36, № 4. - P. 469-481.Lovett D.W., Cross K.R., Van Allen M. The prevalence of amyloids in gingival tissues // Oral Surg. Oral Med. Oral Pathol. - 1965. - Vol. 20, № 4. - P. 444-448.Lovett D.W., Cross K.R., Van Allen M. The prevalence of amyloids in gingival tissues // Oral Surg. Oral Med. Oral Pathol. - 1965. - Vol. 20, № 4. - P. 444-448.Cooke B.E. Biopsy procedures // Oral Surg. Oral Med. Oral Pathol. - 1958. - Vol. 11, № 7. - P. 750-761.Cooke B.E. Biopsy procedures // Oral Surg. Oral Med. Oral Pathol. - 1958. - Vol. 11, № 7. - P. 750-761.Symmers W. Primary amyloidosis: a review // J. Clin. Pathol. - 1956. - Vol. 9, № 3. - P. 187-211.Symmers W. Primary amyloidosis: a review // J. Clin. Pathol. - 1956. - Vol. 9, № 3. - P. 187-211.Dinges H.P., Watzek G., Jesch W. The value of tracing amyloid in the gingiva in the diagnosis of general amyloidosis // Wien Klin. Wochenschr. - 1977. - Vol. 89, № 12. - P. 421-425.Dinges H.P., Watzek G., Jesch W. The value of tracing amyloid in the gingiva in the diagnosis of general amyloidosis // Wien Klin. Wochenschr. - 1977. - Vol. 89, № 12. - P. 421-425.Short L.L., Zoellner H., Hunter N. Association of amyloid P protein with pathology in periodontal tissues // J. Oral Pathol. Med. - 1994. - Vol. 23, № 8. - P. 354-357.Short L.L., Zoellner H., Hunter N. Association of amyloid P protein with pathology in periodontal tissues // J. Oral Pathol. Med. - 1994. - Vol. 23, № 8. - P. 354-357.Short L.L., Zoellner H., Hunter N. Extraction of amyloid-like fi brils from chronically infl amed periodontal tissues // J. Oral Pathol. Med. - 1994. - Vol. 23, № 8. - P. 358-363.Short L.L., Zoellner H., Hunter N. Extraction of amyloid-like fi brils from chronically infl amed periodontal tissues // J. Oral Pathol. Med. - 1994. - Vol. 23, № 8. - P. 358-363.Madani M., Harwick R.D., Chen S.Y., Miller A.S. Amyloidosis of the oral cavity: report of fi ve cases // Compendium. - 1991. - Vol. 10, № 5. - P. 336, 338-342.Madani M., Harwick R.D., Chen S.Y., Miller A.S. Amyloidosis of the oral cavity: report of fi ve cases // Compendium. - 1991. - Vol. 10, № 5. - P. 336, 338-342.Nandapalan V., Jones T.M., Morar P. et al. Localized amyloidosis of the parotid gland: a case report and review of the localized amyloidosis of the head and neck // Head Neck. - 1998. - Vol. 20, № 1. - P. 73-78.Nandapalan V., Jones T.M., Morar P. et al. Localized amyloidosis of the parotid gland: a case report and review of the localized amyloidosis of the head and neck // Head Neck. - 1998. - Vol. 20, № 1. - P. 73-78.Delgado W.A., Mosqueda A. A highly sensitive method for diagnosis of secondary amyloidosis by labial salivary gland biopsy // J. Oral Pathol. Med. - 1989. - Vol. 18, № 5. - P. 310-314.Delgado W.A., Mosqueda A. A highly sensitive method for diagnosis of secondary amyloidosis by labial salivary gland biopsy // J. Oral Pathol. Med. - 1989. - Vol. 18, № 5. - P. 310-314.Hachulla E., Janin A., Flipo R.M. et al. Labial salivary gland biopsy is a reliable test for the diagnosis of primary and secondary amyloidosis. A prospective clinical and immunohistologic study in 59 patients // Arthritis Rheum. - 1993. - Vol. 36, № 5. - P. 691-697.Hachulla E., Janin A., Flipo R.M. et al. Labial salivary gland biopsy is a reliable test for the diagnosis of primary and secondary amyloidosis. A prospective clinical and immunohistologic study in 59 patients // Arthritis Rheum. - 1993. - Vol. 36, № 5. - P. 691-697.Garret J.A. Amyloid deposits of the nose and maxillary sinuses // Arch. Otolaryngol. - 1968. - Vol. 87. - P. 411-412.Garret J.A. Amyloid deposits of the nose and maxillary sinuses // Arch. Otolaryngol. - 1968. - Vol. 87. - P. 411-412.

The authors declare that there are no conflicts of interest present.