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A 77-year-old man born in Yamagata Prefecture, Japan was referred to our hospital because of paresthesia in the distal portion of his extremities. His medical history consisted of several episodes of syncope and constipation since he was 50 years old. Neurological and electrophysiological examinations revealed a sensori-motor neuropathy. The sural nerve biopsy showed amyloid deposition as revealed by direct fast scarlet (DFS) stain (Picture 1A). No demyelination or axonal changes were apparent.doi:10.2169/internalmedicine.49.4052 pmid:21048379 fatcat:2s6zdr4dungdbnttw4bjeqw6ua