succimer and Nephritis--Interstitial

There are many spectrums in renal diseases which induce tubulointerstitial nephropathy (TIN). Primarily, the renal tubule and interstitium are involved but glomerular and vascular lesions are found in the chronic course of TIN. Renal scintigraphy is poor for evaluating characteristic aspects of tubular function of TIN but demonstrate individual renal function as a whole. Particularly, measurement of the 99m-Tc-DMSA renal uptake rate is useful for evaluating a functioning tubular mass.

Topics: Humans; Kidney; Nephritis, Interstitial; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, 99mTcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease.

Topics: Acute Kidney Injury; Adult; Aged; Embolism; Female; Gallium Radioisotopes; Humans; Iodine Radioisotopes; Iodohippuric Acid; Kidney Failure, Chronic; Kidney Neoplasms; Male; Middle Aged; Nephritis, Interstitial; Organotechnetium Compounds; Pentetic Acid; Pyelonephritis; Radionuclide Imaging; Renal Artery Obstruction; Succimer; Sugar Acids; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

Topics: Adolescent; Diagnosis, Differential; Female; Humans; Nephritis, Interstitial; Radionuclide Imaging; Succimer; Technetium; Uveitis

A 39-year-old woman was hospitalized for nausea, diarrhea, vomiting, and weakness of unknown etiology. Her condition progressively deteriorated and she developed multiple organ failure and tetraplegia. The diagnosis of inorganic arsenic poisoning was established by measurements of arsenic in urine and serum, showing 2,000 microg/L (normal < 10 microg/L) and 290 mug/Kg (normal < 2 microg/Kg), respectively. Hair arsenic was 57 mg/kg (normal < 0.2 mg/kg). Chelating therapy with 2.3-dimercaptosuccinic acid (DMSA) 600 mg three times daily was given for a period of 45 days with three abruption periods during a total of 13 days. The clinical manifestations of arsenic toxicosis disappeared very slowly and five years after the hospitalization she still suffers from peripheral neuropathy. Although the use of DMSA was associated with increased urinary elimination of arsenic and a decrease in blood arsenic concentrations, DMSA treatment probably had no significant effect on the total body clearance in our patient. The source of the poisoning was never detected, nor the motivation behind it. Criminal intent was suspected, but no verdict was given.

Topics: Adult; Antidotes; Arsenic; Arsenic Poisoning; Chelating Agents; Critical Care; Electromyography; Female; Hair; Humans; Mass Spectrometry; Nephritis, Interstitial; Paresthesia; Spectrophotometry, Atomic; Succimer; Walking

Four patients with the clinical diagnosis of nephronophthisis are presented, all having a very poor renal uptake of 99mtechnetium-dimercaptosuccinic acid (99mTc-DMSA) but clearly visualized kidneys on early images with 99mtechnetium-mercaptoacetyltriglycine and a normal or almost normal renogram. There was no difference between a young patient in an early stage of the disease and the other three patients with more advanced renal disease. In contrast, a patient with tubulointerstitial nephritis with uveitis had considerably better renal uptake of 99mTc-DMSA despite impaired renal function. We suggest that the specific tubular function defect in nephronophthisis might be the cause of the poor uptake of 99mTc-DMSA. We also recommend the method to support the clinical suspicion of nephronophthisis, even in the early stages of the disease.

Topics: Adolescent; Adult; Biopsy; Child, Preschool; Female; Humans; Kidney; Male; Nephritis, Interstitial; Organotechnetium Compounds; Radioisotope Renography; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Mertiatide

We present a patient with tubulointerstitial renal disease and poor renal 99mTc-DMSA uptake. A 99mTc-DTPA scan was normal and the creatinine clearance only minimally decreased. In this case, 99mTc-DMSA uptake did not correlate with "global renal function," but rather with the functioning tubular mass.

Topics: Adult; Humans; Kidney; Male; Nephritis, Interstitial; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate