99mTc-trimethyl-BrIDA scintigraphy in HIV-related cholangiopathy.
A HIV-infected 37-year-old man with diffuse mid-abdominal pain and elevated liver enzymes was sequentially studied by sonography, computed tomography (CT), 99mTc-trimethyl-BrIDA scintigraphy and endoscopic retrograde cholangiopancreatography (ERCP). CT and sonography did not lead to a final diagnosis. Cholescintigraphy showed signs of cholecystitis and sclerosing cholangitis with intra- and extrahepatic bile duct dilatation. These findings could be confirmed by ERCP, rendering HIV-associated cholepathy probable. Cytomegalovirus infection was demonstrated by polymerase chain reaction from bile fluid and the presence of cryptosporidia infection in a histology specimen isolated by ERCP. Therefore, biliary scintigraphy seems promising for screening for HIV-associated cholangio- and cholecystopathy, being less invasive and less bothering for the patient than ERCP.
Bair
H J
HJ
Department of Nuclear Medicine, University of Erlangen-Nürnberg, Germany.
Behr
T
T
Rubbert
A
A
Becker
W
W
Wolf
F
F
D000328:Adult; D000814:Aniline Compounds; D001652:Bile Ducts / Q000000981:diagnostic imaging; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D002764:Cholecystitis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D005998:Glycine; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007098:Imino Acids; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D000814:Aniline Compounds; D007098:Imino Acids; D015609:Organotechnetium Compounds; C034837:technetium Tc 99m mebrofenin; D005998:Glycine