Major advances in imaging such as scintigraphy with bone tracer and cardiac magnetic resonance (CMR) have heralded a non-invasive approach to diagnosis of ATTR-CA, which can now be achieved without recourse to histological demonstration of amyloid in ≈70% of cases.8 Furthermore, landmark developments in therapies that inhibit hepatic synthesis of TTR, stabilize the tetramer, or disrupt fibrils have been reported to slow or halt disease progression in ATTR-PN and to improve survival in ATTR-CA.9 This evidence concerns the gene TTR and poikiloderma with neutropenia.