99mTc-white cell scanning to detect gut inflammation in children with inflammatory bowel diseases or spondyloarthropathies.
OBJECTIVE
Gut inflammation is a common feature shared by inflammatory bowel diseases (IBD) and the spondyloarthropathies (SpA). The aim of the present study was to compare the reliability of a number of non-invasive investigations for the detection of an inflammatory process of the intestine.


METHODS
Forty-two children were studied: (i) patients with a previous diagnosis of IBD (group A); (ii) patients with suspected IBD (group B); and (iii) patients with predominantly rheumatological manifestations associated with gastrointestinal symptoms (group C). All the patients were studied using 99mTechnetium-HMPAO labelled white cell scanning (99mTc-WCS), and abdominal ultrasound (US). In addition the ESR, serum class A immunoglobulins, faecal occult blood (OB) and faecal alpha 1-antitripsin level (F alpha 1-AT) were determined. Colonoscopy plus multiple biopsies and radiological study of the intestine were used as gold standards.


RESULTS
99mTc-WCS showed the highest sensitivity (85%) and specificity (100%) in detecting the presence of gut inflammation. This was followed by ESR and faecal occult blood (63% sensitivity, 44% specificity), F alpha 1-AT (43% sensitivity, 44% specificity) and IgA (42% sensitivity, 88% specificity). Ultrasound was informative in 28% of the active/affected patients, with a specificity of 75%.


CONCLUSIONS
Although ileo-pancolonscopy remains the gold standard for the histological characterisation of gut inflammation, 99mTc-WCS represents the most reliable non-invasive test for its detection.
Barabino
A
A
Pediatric Gastroenterology Unit, G. Gaslini Scientific Institute for Children, Genoa, Italy.
Gattorno
M
M
Cabria
M
M
Sormani
M P
MP
Occhi
M
M
Villavecchia
G
G
Gandullia
P
P
Buoncompagni
A
A
Castellano
E
E
Picco
P
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000276:immunology*; D008297:Male; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging / Q000592:standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013122:Spinal Diseases / Q000150:complications / Q000276:immunology*; D019690:Technetium Tc 99m Exametazime
D019690:Technetium Tc 99m Exametazime