sodium-pertechnetate-tc-99m and Acquired-Immunodeficiency-Syndrome

Intense thyroidal Ga-67 accumulation was seen in a man with AIDS imaged for suspected Pneumocystis carinii pneumonia. Concurrent Tc-99m pertechnetate thyroid scanning demonstrated absent trapping, helping establish the diagnosis of painless thyroiditis. Occult hyperthyroidism, and not pulmonary infection, may have been responsible for the patient's original presenting symptoms.

Topics: Acquired Immunodeficiency Syndrome; Adult; Diagnosis, Differential; Gallium Radioisotopes; Humans; Male; Pneumonia, Pneumocystis; Sodium Pertechnetate Tc 99m; Thyroiditis, Subacute; Tomography, Emission-Computed, Single-Photon

Technegas, an ultra-fine dry aerosol with prolonged retention in the lungs, can be modified by altering the atmosphere in which the carbon particles are generated. The modified Technegas has much faster clearance from the lung. The half-time pulmonary clearances with modified Technegas were compared to those obtained with conventional 99mTc DTPA aerosol in 50 patients. Interstitial lung disease was suspected in 12 while 38 were infected with the human immunodeficiency virus and suspected of having opportunistic lung infection. In 22 nonsmokers in whom no evidence of active pulmonary pathology was demonstrable, the mean half-time with DTPA was 52.5 min whereas the mean half-time with modified aerosol was 10.1 min. The mean half-time in 14 smokers in whom there was also no evidence of active pulmonary disease was 28.3 min with DTPA and 7.0 min with the modified method. In the 14 patients in whom altered pulmonary permeability was demonstrated by a short DTPA half-time (mean 4.8 min) there was also an accelerated half-time with modified Technegas (mean 2.5 min). It is concluded that the modified Technegas procedure offers a simple but accurate method of identifying individuals having opportunistic infection or other diffuse lung pathology.

Topics: Acquired Immunodeficiency Syndrome; Adult; Aerosols; Female; Graphite; Half-Life; Humans; Lung; Male; Opportunistic Infections; Pneumonia, Pneumocystis; Radionuclide Imaging; Smoking; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Pentetate

Topics: Acquired Immunodeficiency Syndrome; Aerosols; Graphite; Humans; Lung; Lung Diseases; Opportunistic Infections; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Structure-Activity Relationship; Ventilation-Perfusion Ratio

We have assessed right and left ventricular function by multigated radionuclide ventriculography in 12 consecutive patients with acquired immunodeficiency syndrome (AIDS) grouped according to the CDC classification system for HIV infection. Results were correlated with clinical, electrocardiographic and echocardiographic findings. Clinical examination and chest x-ray films showed no evidence of acute cardiac or pulmonary pathology. Five patients had evidence of ventricular dysfunction by radionuclide ventriculography along with significant ECG abnormalities. Three patients had abnormal ECG findings with normal ejection fractions. Echocardiography showed no evidence of significant valvulopathy or pericardial disease except for one patient with fibrinous strands associated with the pericardium. Decreased ejection fractions did not correlate with disease classification, risk group or survival. This study suggests that a major percentage of AIDS patients have some evidence of cardiac abnormalities. We conclude that abnormal ECG findings in an AIDS patient should alert the clinician to possible underlying ventricular dysfunction.

Topics: Acquired Immunodeficiency Syndrome; Adult; Echocardiography; Electrocardiography; Female; Heart; Heart Ventricles; Humans; Male; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Stroke Volume