Lung-uptake and -washout of MIBG in sarcoidosis.
BACKGROUND
The aim of this study was to evaluate the uptake and -washout of I-123 meta-iodobenzylguanidine (MIBG), reflecting norepinephrine metabolism, in the lungs in patients with sarcoidosis.


METHODS
Lung I-123 MIBG kinetics was assessed in 43 patients with sarcoidosis. The range of disease duration was 1-16 years (median: 3 years). Thirteen patients had radiographic stage 0-I, 30 patients had radiographic stage II-IV. Serological clinical parameters and small fibre neuropathy, as assessed by temperature threshold testing (TTT) were measured in 39/43 patients. 31/39 patients had an abnormal TTT. Eleven healthy controls participated in this study. Both dual head planar and dual headed SPECT images of the thoracic regions were made. The uptake of I-123 MIBG and the washout percentage were calculated in sarcoidosis patients and compared with the healthy persons.


RESULTS
Lung I-123 MIBG uptake in patients with sarcoidosis did not differ from controls. The lung washout of I-123 MIBG was significantly (p<or=0.01) decreased in sarcoidosis. Remarkably this was most clearly seen in patients with an abnormal TTT and in patients with more advanced radiographic pulmonary involvement (radiographic stages II-IV) but not in patients with decreased lung function (FVC<80% or DLCO<80%).


CONCLUSIONS
The inflammatory process of the lungs in sarcoidosis seems not to affect pulmonary vasculature. In sarcoidosis decreased lung washout of I-123 MIBG might, at least partly, be explained by sympathetic autonomic nerve dysfunction. Future studies are needed to explore the clinical relevance of this observation.
Jonker
Gerard J
GJ
Department of Respiratory Medicine, Maxima Medical Center, Eindhoven, The Netherlands.
Smulders
Nanda M
NM
van Kroonenburgh
Marinus J
MJ
Halders
Serve
S
de Vries
Jolanda
J
Faber
Carin G
CG
Drent
Marjolein
M
D019797:3-Iodobenzylguanidine / Q000493:pharmacokinetics*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D017565:Sarcoidosis, Pulmonary / Q000378:metabolism*; D013697:Thermosensing; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine