indium-oxine and Fever

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.. 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.. 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.. 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.

Topics: Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Bacterial Infections; Blood Platelets; Diagnosis, Differential; Embolization, Therapeutic; Female; Fever; Graft Rejection; Humans; Indium Radioisotopes; Kidney; Kidney Transplantation; Male; Middle Aged; Nephrectomy; Organometallic Compounds; Oxyquinoline; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Renal Dialysis; Sensitivity and Specificity; Transplantation, Homologous

Persistent fever in a 60-yr-old man with polycystic kidney and liver diseases and bilateral hip prostheses was presented in this study. Multiple diagnostic tests failed to localize a source of infection. Subsequently, a combination of a 111In-oxine labeled WBC and 99mTc-sulfur colloid scans (and computer subtraction) demonstrated abnormally increased WBC activity in the left lobe of the liver, thus, diagnosis of an infected cyst (or cysts) was made. The patient responded to the treatment with antibiotics. This article discusses the clinical features of polycystic disease of the liver and kidneys. Infection in cysts are discussed as well as radiographic and scintigraphic investigations that can be used to diagnose and localize infection in a cyst.

Topics: Cysts; Fever; Hip Prosthesis; Humans; Indium Radioisotopes; Infections; Leukocytes; Liver Diseases; Male; Middle Aged; Organometallic Compounds; Oxyquinoline; Polycystic Kidney, Autosomal Dominant; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid