To the Editor:—
I was interested in the letter by Vallat and Dunoyer in the May 1979 issue of the Archives (36:323, 1979) about the familial occurrence of carpal tunnel syndrome (CTS). I agree that familial CTS is not rare. Indeed, at Johns Hopkins Hospital (Baltimore), 17% of CTS cases had familial incidence.1 (Theirs may be a special situation since they are a genetic referral center.)Another point to be made is that patients with CTS from amyloidosis do not always have amyloid in the flexor retinaculum. Lambird and Harmann1 found it in seven of ten patients with amyloidosis, and Mahloudji et al2 found it in eight of 12 patients with amyloidosis. I have two patients with CTS in whom an ultra-structural examination and Congo red stain of the ligaments did not show evidence of amyloid, but in whom rectal biopsy specimens showed amyloid.I think that
Massey EW. Familial Carpal Tunnel Syndrome. Arch Neurol. 1979;36(11):727. doi:10.1001/archneur.1979.00500470097025
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