Abstract: A 65yearold male patient treated with maintenance hemodialysis for 34 years.He presented with pain and numbness in the first three fingers (thumb,index,middle and half of the ring) of right hand,atrophy of the thenar eminence muscles and high levels of β2microglobulins.Nerve conduction studies conformed median nerve damage.MRI indiated multiple cystic changes in carpal bone with intraarticular synovial thickening.Carpal tunnel syndrome(CTS) is considered,surgical decompression of carpal tunnel is offered to patient.Congo red staining and immunohistochemica analysis were positive for β2microglobulins of transverse carpal ligament.The final diagnosis was dialysisrelated amyloidosis (DRA).

Key words: hemodialysis,&beta, 2-microglobulin,carpal tunnel syndrome,dialysis related amyloidosis