The role of gallium-67-citrate in the detection of phenytoin-induced pneumonitis.
A patient with a history of cardiac transplant presented with a fever of undetermined etiology. The patient had been on multiple medications, including phenytoin, which can occasionally cause allergic or hypersensitivity pneumonitis. A chest x-ray and CT scan of the chest revealed no active disease. A 67Ga study was obtained after intravenous administration of 377.4 MBq (10.2 mCi) of 67Ga-citrate. The images showed diffuse intense lung uptake bilaterally. Bronchoscopic biopsy revealed hypersensitivity pneumonitis. Phenytoin was withdrawn and corticosteroid was started in therapeutic doses. A follow-up gallium study obtained 25 days after the baseline demonstrated marked improvement in the lungs with concurrent clinical recovery. This case illustrates the usefulness of 67Ga in the detection of drug-induced pneumonitis and in the follow-up of response to therapy.
Khan
A S
AS
Department of Radiation Oncology and Nuclear Medicine, Hahnemann University, Philadelphia, Pennsylvania 19102-1192.
Dadparvar
S
S
Brown
S J
SJ
Slizofski
W J
WJ
Roman
R
R
Krishna
L
L
Meihoffer
M
M
D000542:Alveolitis, Extrinsic Allergic / Q000139:chemically induced* / Q000000981:diagnostic imaging; D002951:Citrates; D019343:Citric Acid; D004342:Drug Hypersensitivity / Q000000981:diagnostic imaging*; D005710:Gallium Radioisotopes; D016027:Heart Transplantation; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects* / Q000627:therapeutic use; D011877:Radionuclide Imaging
D002951:Citrates; D005710:Gallium Radioisotopes; D019343:Citric Acid; D010672:Phenytoin