technetium-tc-99m-mebrofenin and HIV-Infections

A HIV-infected 37-year-old man with diffuse mid-abdominal pain and elevated liver enzymes was sequentially studied by sonography, computed tomography (CT), 99mTc-trimethyl-BrIDA scintigraphy and endoscopic retrograde cholangiopancreatography (ERCP). CT and sonography did not lead to a final diagnosis. Cholescintigraphy showed signs of cholecystitis and sclerosing cholangitis with intra- and extrahepatic bile duct dilatation. These findings could be confirmed by ERCP, rendering HIV-associated cholepathy probable. Cytomegalovirus infection was demonstrated by polymerase chain reaction from bile fluid and the presence of cryptosporidia infection in a histology specimen isolated by ERCP. Therefore, biliary scintigraphy seems promising for screening for HIV-associated cholangio- and cholecystopathy, being less invasive and less bothering for the patient than ERCP.

Topics: Adult; Aniline Compounds; Bile Ducts; Cholangiopancreatography, Endoscopic Retrograde; Cholangitis, Sclerosing; Cholecystitis; Glycine; HIV Infections; Humans; Imino Acids; Liver; Male; Organotechnetium Compounds; Radionuclide Imaging; Tomography, X-Ray Computed; Ultrasonography