**Author Listing - Lead/ Submitting Author (we will be communicating with this individual): Name, Institution, City and State where the work was done. Co-authors will be added in a separate section.**
Julie A Vrana;   Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

**Main Body of the Abstract**
Background: Iatrogenic amyloidosis is caused by repeated subcutaneous injections of protein or peptide based medications, two of which (insulin and glucagon-like peptide-1 (GLP-1) analogs) are clinically in wide use. Although AIns has been well-described, only two cases of AGLP1 have been reported.
Aim: To characterize patient and proteomic variables in AGLP1 amyloidomas.
Design: Twelve cases of AGLP1 amyloidosis identified by mass spectrometry-based proteomics (LC-MS/MS) were reviewed. Demographic data were collected in all cases and glucagon immunohistochemistry performed (n=7).
Results: There were 7 men and 5 women; median age 68 years (range 54 – 78 years). Injected GLP-1 analogs included liraglutide (N=6), semaglutide (N=2), and dulaglutide (N=1); the other cases were unknown. LC-MS/MS was performed on 4 abdominal wall fat aspirates and on microdissected tissue from 7 abdominal fat pad biopsies and 1 upper arm soft tissue biopsy.  The AGLP1 proteome was characterized by increased levels of the amyloid signature proteins APOA4 and APOE, low/absent SAP, and increased GLP-1 spectra. In 2 patients who had a history of both insulin and GLP-1 analog injections, AIns was also identified. All other cases showed the absence of other amyloid precursor proteins.
Conclusions: Although iatrogenic amyloidosis is typically a localized benign condition, these cases are often submitted for typing to rule out systemic amyloidosis, thus highlighting the importance of identifying the precise amyloid type for proper patient care. With the rise in GLP-1 analog use for diabetes and metabolic disease, the frequency of iatrogenic AGLP1 amyloidomas is likely to increase.



Mass Spectrometry identification of 12 cases of AGLP1 (Glucagon-like peptide 1 analog) amyloidosis  PC13 (#141)

We invite you to attend the XIX International Symposium on Amyloidosis to be held in Rochester, MN.

This symposium is organized as a hybrid meeting (with the focus on in-person) held from Sunday, May 26 through Thursday, May 30, 2024.

Together with the ISA Board and members of Mayo Clinic, a very attractive scientific hybrid program is being planned. The program will cover a variety of types of systemic amyloidosis: ATTR (hereditary and wild-type), AL (light-chain), AA and less frequent forms. There will be key lectures, specific symposia including those company sponsored, oral presentations and poster sessions of accepted abstracts.

COURSE DESCRIPTION
This program will provide a comprehensive review of state-of-the-art education in systemic amyloidosis: basic science, pathophysiology, diagnosis, current and emerging treatments. Scientific presentations will include competitive oral and poster abstracts. The rapid evolution of scientific discovery and expanding treatment options has created tremendous interest in the field and this meeting will fill and important gap in educating scientists and clinicians.