Abdominal scintigraphy using technetium Tc 99m hexylmethylpropylene amine oxime-labeled leukocytes in patients with seronegative spondyloarthropathies.
OBJECTIVE
To assess the potential benefits of technetium Tc 99m hexylmethylpropylene amine oxime (Tc 99m HMPAO)-labeled leukocyte scintigraphy in a group of patients with spondyloarthropathies (SpAs), overt gastrointestinal symptoms, and negative extensive endoscopic/radiologic test results.


METHODS
Ten patients with SpAs and overt gastrointestinal symptoms were included in this study. All patients underwent colonoscopy and small bowel barium studies, and results were negative. Abdominal scintigraphy with Tc 99m HMPAO-labeled leukocytes was performed in all the patients. Clinical and laboratory data and response to treatment was recorded.


RESULTS
The Tc 99m HMPAO-labeled leukocyte scintigraphy was positive in 5 of 10 patients, demonstrating uptake at the terminal ileum which is very suggestive of Crohn disease. The 5 scintigraphically positive patients were treated with sulfasalazine (SSZ). Four patients responded to SSZ with significant improvement of both gastrointestinal and joint symptoms.


CONCLUSIONS
In 5 of 10 patients with SpA and suspected inflammatory bowel disease on clinical grounds, evidence of inflammatory bowel disease was shown by scintigraphic studies in which conventional invasive procedures failed. Tc 99m HMPAO-labeled leukocyte scintigraphy should be considered in the evaluation of patients with SpA.
Elkayam
Ori
O
Department of Rheumatology, Tel Aviv Sourasky Medical Center and the Sackler Faculty of Medicine, University of Tel Aviv, Tel Aviv, Israel. oribe14@netvision.net.il
Paran
Daphna
D
Even-Sapir
Einat
E
Litinsky
Irena
I
Wigler
Irena
I
Yaron
Michael
M
Caspi
Dan
D
D000005:Abdomen / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D003424:Crohn Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging / Q000379:methods; D019275:Radiopharmaceuticals; D012698:Serologic Tests; D025242:Spondylarthropathies / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D019690:Technetium Tc 99m Exametazime
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime