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Editor,—I read with great interest the article by Stewart et al 1 on late onset corneal dystrophy with systemic amyloidosis (familial amyloidosis of the Finnish type/Merotoja syndrome) and their claim that this was the first case described in the UK. I would like to point out our case report published in the BJO in November 1999.2 We described a classic case of Merotoja syndrome in an English woman which was confirmed by genetic testing of the patient and her daughter who both demonstrated the point mutation on the gelsolin gene located on chromosome 9.
The authors bring to our attention a second family with this disorder and rightly state that the concept of a geographically limited disorder—namely, familial amyloidosis of the Finnish type, must be treated with caution as indeed the condition can occur elsewhere.
In our patient, immunocytochemistry of the corneal button removed at keratoplasty showed no labelling of the amyloid deposits with antibodies to pre-albumin, amyloid A, and amyloid P. This was in contrast with other studies where amyloid stained with antisera to serum amyloid P.3 Whether this represents a subtype of the condition is uncertain and it would be interesting to compare findings with Stewart et al 1 although there is no mention of immunocytochemistry results in their paper.
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