pyrophosphate and Sarcoidosis

Topics: Acidosis, Renal Tubular; Bacterial Infections; Citrates; Crystallization; Cystinuria; Diphosphates; Female; Gastrointestinal Diseases; Humans; Hypercalcemia; Hyperparathyroidism; Magnesium; Male; Metabolism, Inborn Errors; Mucoproteins; Oxalates; Quaternary Ammonium Compounds; Sarcoidosis; Solubility; Uric Acid; Urinary Calculi; Vitamin D; Xanthine Oxidase

A case report of patient with cardiac sarcoidosis is presented. Advanced atrioventricular (AV) block and abnormalities of radionuclide imaging were improved by steroid therapy. We stress the effectiveness of steroid therapy together with usefulness of radionuclide techniques.

Topics: Cardiomyopathies; Diphosphates; Female; Heart Block; Humans; Middle Aged; Pacemaker, Artificial; Prednisone; Sarcoidosis; Technetium; Technetium Tc 99m Pyrophosphate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

This study was aimed to determine whether nuclear methods were useful for examining cardiac pathology and for making a decision of corticosteroid therapy in patients with sarcoidosis. Thirty six patients were divided into two groups; GpA consisted of 19 patients with cardiac sarcoidosis and abnormal ECG findings, and GpB of 17 patients with sarcoidosis without ECG abnormalities. Cardiac uptake of 67Ga-citrate in 2 and 99mTc-PYP in one of GpA was observed and steroid therapy resulted in the disappearance of the uptake. 201Tl-CL cardiac tomograms disclosed perfusion defects in 10 of 14 patients (71%) in GpA, including defects with redistribution in 8 of the 10 pts, but only one case in GpB. Radionuclide ventriculography using 99mTc-RBC revealed abnormal response of left ventricular (LV) function to exercise and LV dysfunction in GpA. These data suggest that nuclear study is a useful tool for diagnosing cardiac sarcoidosis, evaluating therapeutic effectiveness and long-term follow-up in patients with sarcoidosis.

Topics: Adult; Cardiomyopathies; Diphosphates; Female; Gallium Radioisotopes; Heart; Humans; Male; Middle Aged; Myocardium; Radionuclide Imaging; Sarcoidosis; Technetium; Technetium Tc 99m Pyrophosphate; Thallium Radioisotopes

Marked clinical or electrocardiographic changes, suggestive of heart disease, were only detected in 14 (7%) of 190 patients with sarcoidosis. Diffuse myocardial accumulation of 99mTc pyrophosphate (2+ or 3+) was seen in 12 (43%) of 28 patients with active sarcoidosis. Repeated scintigraphy showed normal values in 3 patients after a course of corticosteroid therapy. Echocardiographic signs of heart disease were found in 33 (37%) of 89 patients, including left-ventricular contractility disorders in 21, thinning (5) or thickening (7) of left-ventricular wall and ventricular septum, mitral prolapse in 3 and limited pericardial exudate in 5. Signs of pulmonary heart were detected in 17 patients. Clinical and electrocardiographic symptoms of cardiac sarcoidosis were significantly more frequent in patients with myocardial Tc-pyrophosphate accumulation and echocardiographic changes. It is suggested that myocardial Tc-pyrophosphate scintigraphy and echocardiography may be used for the diagnosis of cardiac sarcoidosis, including its latent forms.

Topics: Adult; Cardiomyopathies; Diphosphates; Echocardiography; Electrocardiography; False Negative Reactions; Heart; Humans; Middle Aged; Radionuclide Imaging; Sarcoidosis; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adult; Cardiomyopathies; Diphosphates; Echocardiography; Humans; Sarcoidosis; Technetium; Technetium Tc 99m Pyrophosphate

A patient had severe congestive cardiomyopathy secondary to myocardial sarcoidosis. The clinical diagnosis was confirmed by radionuclide ventriculography, thallium 201 (201Tl), gallium-67 (67Ga), and technetium-99m (99mTc) pyrophosphate (TcPYP) scintigraphy. Myocardial TcPYP uptake has not been reported previously in sarcoidosis. In this patient, TcPYP was as useful as gallium scanning and thallium imaging in documenting the myocardial process.

Topics: Adult; Cardiomyopathies; Diphosphates; Female; Gallium Radioisotopes; Heart; Humans; Radioisotopes; Radionuclide Imaging; Sarcoidosis; Technetium; Technetium Tc 99m Pyrophosphate; Thallium

Comparative studies between routine roentgenograms and scintiphotographs using 99mTc-pyrophosphate, of the hands and feet are documented in three cases of bone sarcoidosis. All the abnormal roentgenographic findings were also detected by 99mTc-pyrophosphate bone imaging. However, several areas of increased radiopharmaceutical uptake were found in areas with normal roentgenographic studies. These results suggest that the 99mTc-pyrophosphate bone scintiphotographs might be more sensitive than radiographs in the localization of the bone involvement in sarcoidosis.

Topics: Adult; Bone Diseases; Diphosphates; Female; Foot; Humans; Male; Middle Aged; Radiography; Radionuclide Imaging; Sarcoidosis; Technetium

99Tcm-Sn pyrophosphate bone scans of 250 patients referred for skeletal metastatic survey were analysed to determine the frequency of abnormal extra-osseous localization and the various pathological causes. Twenty-six patients demonstrated abnormal extra-osseous concentration. There were three false positives. Sixty-five per cent of the extra-osseous lesions concentrating pyrophosphate were malignant (carcinoma of lung and breast, metastatic hepatic carcinoma, chondrosarcoma) and the remainder were benign lesions, e.g. sarcoidosis, soft-tissue calcification, post-surgical and irradiation sites. An incidental finding was the unusual frequency of accumulation of pyrophosphate in various joints, especially the knees and shoulders in asymptomatic patients above 70 years of age.

Topics: Age Factors; Aged; Bone Neoplasms; Breast Neoplasms; Diphosphates; False Positive Reactions; Humans; Joints; Liver Neoplasms; Lung Neoplasms; Middle Aged; Neoplasm Metastasis; Neoplasms; Radionuclide Imaging; Sarcoidosis; Technetium; Tin

Topics: Antibodies, Antinuclear; Arthritis, Rheumatoid; Biopsy; Connective Tissue; Dermatomyositis; Diphosphates; Gout; Humans; Hyperparathyroidism; Inflammation; Joint Diseases; Lupus Erythematosus, Systemic; Neutrophils; Polyarteritis Nodosa; Psoriasis; Rheumatoid Factor; Salicylates; Sarcoidosis; Spondylitis, Ankylosing; Synovial Fluid; Synovial Membrane; Uric Acid