title: [Usefulness of 111In-oxine labelled platelets in the management of febrile syndrome in dialysis patients with non-functional renal allografts].
abstract: 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.
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clínic, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Ortín-Pérez
authors.forename: D
authors.initials: D
authors.lastname: Fuster
authors.forename: F
authors.initials: F
authors.lastname: Lomeña
authors.forename: J V
authors.initials: JV
authors.lastname: Torregrosa
authors.forename: C
authors.initials: C
authors.lastname: Piera
authors.forename: D
authors.initials: D
authors.lastname: Rodríguez-Puig
authors.forename: J
authors.initials: J
authors.lastname: Duch
authors.forename: S
authors.initials: S
authors.lastname: Rubí
authors.forename: X
authors.initials: X
authors.lastname: Setoain
authors.forename: J M
authors.initials: JM
authors.lastname: Campistol
authors.forename: F
authors.initials: F
authors.lastname: Pons
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007205:Indium Radioisotopes; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C032950:indium oxine; D015125:Oxyquinoline