Immunoscintigraphy with a 99Tcm-labelled anti-granulocyte monoclonal antibody in patients with human immunodeficiency virus infection and AIDS.
The value of immunoscintigraphy with technetium-99m (99Tcm) labelled anti-granulocyte monoclonal antibody (BW250/183) was studied prospectively in human immunodeficiency virus (HIV-1) antibody-positive patients presenting with fever without localizing symptoms or signs. Twenty-three studies were performed in 23 patients and the results of 99Tcm-anti-granulocyte imaging were compared with the definitive microbiological or cytological diagnosis. Twenty-one patients had an infective cause of pyrexia, one patient had disseminated lymphoma and one Kaposi sarcoma. 99Tcm-anti-granulocyte antibody imaging correctly identified the sites of infection in only five (24%) patients, four of whom had infective colitis (one also had bacterial pneumonia) and one of whom had cellulitis. Sixteen foci of infection were not localized by 99Tcm-anti-granulocyte immunoscintigraphy (false-negative scans). Six of these patients had Pneumocystis carinii pneumonia; other diagnoses in this group included bacterial or fungal pneumonia and bacteraemia secondary to line infections. 99Tcm-anti-granulocyte antibody did not accumulate in the patients with disseminated lymphoma and Kaposi sarcoma (true-negative scans). 99Tcm-anti-granulocyte imaging, therefore, appears useful in identifying extrathoracic infection in HIV-1 positive patients. Its lack of sensitivity for the identification of pulmonary infection means that its role in the investigation of HIV-1 antibody-positive patients with fever without localizing symptoms or signs is limited.
Prvulovich
E M
EM
Institute of Nuclear Medicine, University College London Medical School, UK.
Miller
R F
RF
Costa
D C
DC
Severn
A
A
Corbett
E
E
Bomanji
J
J
Becker
W S
WS
Ell
P J
PJ
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000328:Adult; D000911:Antibodies, Monoclonal / Q000276:immunology; D000918:Antibody Specificity; D001424:Bacterial Infections / Q000000981:diagnostic imaging; D005188:False Negative Reactions; D005189:False Positive Reactions; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging*; D006098:Granulocytes / Q000276:immunology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D018796:Immunoconjugates; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000209:etiology; D016483:Lymphoma, AIDS-Related / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000000981:diagnostic imaging; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000209:etiology; D011020:Pneumonia, Pneumocystis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D016719:Radioimmunodetection; D012514:Sarcoma, Kaposi / Q000000981:diagnostic imaging / Q000209:etiology; D013670:Sodium Pertechnetate Tc 99m; D014777:Virus Diseases / Q000000981:diagnostic imaging
D000911:Antibodies, Monoclonal; D018796:Immunoconjugates; D013670:Sodium Pertechnetate Tc 99m