A 75-Year-Old Man Presented to the Clinic Suffering from Numbness

A 75-year-old man presented to the clinic suffering from numbness and tingling in the hands. For the last 3 months, the patient has been experiencing numbness in his hands. There is numbness over the middle, index, and thumb fingers. The patient is a known case of type 2 diabetes mellitus, and end-stage renal disease. The patient has been receiving hemodialysis for the last 10 years. The patient has stable vital signs. on examination, cardiopulmonary examination shows no abnormalities. Physical examination shows bilateral thenar atrophy, with swelling over the wrists bilaterally. which of the following is The underlying pathophysiological process for this patient's presentation?

A) Clonal production of excess free immunoglobulin light chains
B) Cytokine-mediated increased production of amyloid A protein
C) Tissue deposition of beta2-microglobulin
D) Tissue deposition of mutated transthyretin
E) Tissue deposition of wild-type transthyretin

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