pyrophosphate and Liver-Diseases

A patient with AA amyloidosis secondary to ankylosing spondylitis showed intense liver uptake of Tc-99m MDP on bone imaging. The biopsy showed hepatic amyloid deposition. A repeat bone scan with Tc-99m MDP 1 year later was negative, although the clinical signs and liver function tests of the patient had not changed. A mechanism might exist, other than the affinity of amyloid to calcium, which would explain the extraosseous uptake of pyrophosphates and diphosphonates in organs and soft tissues affected by systemic amyloidosis.

Topics: Amyloidosis; Diphosphates; Humans; Liver; Liver Diseases; Male; Middle Aged; Radiography; Radionuclide Imaging; Spondylitis, Ankylosing; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

A prospective, comparative study was made of the efficacy of technetium-99m pyrophosphate (Tc PYP) and technetium-99m methylene diphosphonate (Tc MDP) in detecting soft-tissue amyloidosis. Tc PYP and Tc MDP scans were obtained within ten-day intervals in seven patients with histologically proven amyloidosis. Tc PYP was a better scanning agent for soft-tissue amyloidosis in all patients. Cardiac and hepatic involvement were proved by autopsy in one patient. Involvement of the heart was confirmed by echocardiography in five patients. The potential use of Tc PYP scanning as a screening test for soft-tissue amyloidosis is discussed.

Topics: Adult; Aged; Amyloidosis; Biopsy; Diphosphates; Diphosphonates; Echocardiography; Female; Heart Diseases; Humans; Liver Diseases; Male; Middle Aged; Prospective Studies; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

Topics: Diphosphates; Humans; Liver Diseases; Male; Middle Aged; Myocardial Infarction; Necrosis; Radionuclide Imaging; Technetium