[Usefulness of 111In-oxine labelled platelets in the management of febrile syndrome in dialysis patients with non-functional renal allografts].
OBJECTIVE
To evaluate the usefulness of 111In-oxine-labelled platelet scan in the therapeutic management of prolonged febrile syndrome in dialysis patients with a non-functional renal allograft.


METHODS
One hundred and fifty-eight patients (94 men, 64 women; mean age 44 +/- 9 years) were studied. Duration of fever was 42 days (range 7-112). A total of 68 % of the patients (107/158) were on low doses of corticosteroids (<10 mg/day). Platelet scans were performed 48 hours after reinjection of 111In-ixone-labelled platelets. A platelet uptake index (PUI) was calculated by dividing the cpm/pixel in the allograft by the cpm/pixel in a mirror background. A PUI > or = 1.5 was considered as threshold for immunological fever. The final diagnosis of immunological fever was established when it disappeared after transplantectomy, embolization or high doses of corticosteroid therapy. Fever of non-immunological origin was established when it disappeared after antibiotic therapy.


RESULTS
In 102/158 patients the fever was considered of immunological origin. In 56/158 patients the fever was considered of non immunological origin. Sensitivity and the specificity of the platelet scan was 80 % and 100 %, respectively. All those patients considered as having fever of immunological origin who had PUI <1.5 had been using corticosteroids during platelet scan.


CONCLUSIONS
111In-labelled platelet scintigraphy is a useful technique in the therapeutic management of prolonged febrile syndrome in dialysis patients with non-functional renal allograft. The use of corticosteroids can reduce the sensitivity of 111In- labelled platelet scan.
Ortín-Pérez
J
J
Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España.
Fuster
D
D
Lomeña
F
F
Torregrosa
J V
JV
Piera
C
C
Rodríguez-Puig
D
D
Duch
J
J
Rubí
S
S
Setoain
X
X
Campistol
J M
JM
Pons
F
F
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D001792:Blood Platelets; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D005260:Female; D005334:Fever / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D006084:Graft Rejection / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy; D006801:Humans; D007205:Indium Radioisotopes; D007668:Kidney / Q000000981:diagnostic imaging; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009942:Organometallic Compounds; D015125:Oxyquinoline / Q000031:analogs & derivatives*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D006435:Renal Dialysis; D012680:Sensitivity and Specificity; D014184:Transplantation, Homologous
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C032950:indium oxine; D015125:Oxyquinoline