Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn disease and steroid use.
Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. The authors present the case of a patient with Crohn disease relapse with multiple small-bowel fistulae and mesenteric abscesses. Whereas the Tc-99m WBC scan failed to show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses very well, and these were later confirmed at surgery. This case is presented not only to illustrate the relative sensitivities of a Tc-99m WBC versus an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.
Challa
S
S
Long Beach VA, California, USA.
Lyons
K P
KP
Broekelschen
P
P
Milne
N
N
D018784:Abdominal Abscess / Q000000981:diagnostic imaging / Q000188:drug therapy; D000328:Adult; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D002634:Chemotaxis, Leukocyte / Q000187:drug effects; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005839:Gentamicins / Q000627:therapeutic use; D005938:Glucocorticoids / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy; D007205:Indium Radioisotopes; D007410:Intestinal Diseases / Q000000981:diagnostic imaging; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000188:drug therapy; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007962:Leukocytes / Q000187:drug effects; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging; D008795:Metronidazole / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D009504:Neutrophils / Q000187:drug effects; D010406:Penicillins / Q000627:therapeutic use; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy; D011241:Prednisone / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013667:Technetium
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D005839:Gentamicins; D005938:Glucocorticoids; D007205:Indium Radioisotopes; D010406:Penicillins; D019275:Radiopharmaceuticals; D008795:Metronidazole; D013667:Technetium; D000667:Ampicillin; D011241:Prednisone; D006854:Hydrocortisone