Detection of abnormalities in febrile AIDS patients with In-111-labeled leukocyte and Ga-67 scintigraphy.
Thirty-six patients with acquired immunodeficiency syndrome (AIDS), who were febrile but without localizing signs, underwent indium-111 leukocyte scintigraphy 24 hours after injection of labeled white blood cells (WBCs) and were restudied 48 hours after injection of gallium-67 citrate. Fifty-six abnormalities were identified as possible sources of the fever; 27 were confirmed with biopsy. Of these 27, 15 were identified only on In-111 WBC scans (including colitis, sinusitis, and focal bacterial pneumonia); six, only on Ga-67 scans (predominantly Pneumocystis carinii pneumonia and lymphadenopathy); and six, on both studies (predominantly pulmonary lesions). In-111 WBC scanning revealed 21 of 27 abnormalities (78%) and gallium scanning, 12 of 27 (44%). If only one scintigraphic study has been performed, particularly with Ga-67, a significant number of lesions would not have been detected. The authors believe radionuclide evaluation of the febrile AIDS patient without localizing signs should begin with In-111 WBC scintigraphy. Gallium scanning may be used depending on results of In-111 WBC scans or if there is a high index of suspicion for P carinii pneumonia.
Department of Nuclear Medicine, Mount Sinai Medical Center, New York, NY 10029.
D S
DS
Fineman
C J
CJ
Palestro
C K
CK
Kim
L B
LB
Needle
S
S
Vallabhajosula
R W
RW
Solomon
S J
SJ
Goldsmith
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D001424:Bacterial Infections / Q000150:complications / Q000000981:diagnostic imaging*; D002951:Citrates; D019343:Citric Acid; D003092:Colitis / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology*; D005710:Gallium Radioisotopes; D006801:Humans; D007205:Indium Radioisotopes; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging
D002951:Citrates; D005710:Gallium Radioisotopes; D007205:Indium Radioisotopes; D019343:Citric Acid