Ventura G, Salvatori M, Antoni M, Maiuro G, Galli G, Ortona L; International Conference on AIDS.
Int Conf AIDS. 1992 Jul 19-24; 8: B109 (abstract no. PoB 3135).
Istituto Clinica Malattie Infettive, Universita Cattolica del Sacro Cuore-Roma-Italy.
OBJECTIVE: To evaluate the efficacy and safety of 99Tc-human polyclonal immunoglobulin (99Tc-HIG) scintigraphy in the screening of opportunistic infections and tumors in AIDS patients. METHODS: Twenty-six AIDS patients (pts) with proved or suspected infections (8 Pneumocystis carinii pneumonia (PCP), 2 tuberculosis (TBC), 2 Mycobacterium avium-complex (MAC), 3 bacterial abscesses (BA), 4 interstitial pneumonia (IP) 1 Cytomegalovirus disseminated infection (CMV) and with tumors (4 lymphomas, 1 Kaposi's sarcoma, 1 metastatic seminoma) were studied. All of them were studied also in comparison with 67-Ga scan (GS), chest radiography (X-rays) and high resolution TC scan (HRCT). In all patients whole body HIG scans were obtained 4 and 24 hours after intravenous injection of 20 mCi (740MBq). A semiquantitative index of lung uptake (SQI = counts in the lung ROI/counts in the heart ROI, normalized for unit area) was also determined. GS scan was performed according to standard methods and graded on a scale I to IV. Laboratory tests included CD4+ cell count and, in pts. with pulmonary involvement, blood-gas analysis (pO2) and lactate dehydrogenase (LDH) RESULTS: A positive concordance between HIG, GS and HRCT was observed in 10 cases with PCP (7/8-87.5%) and BA (3/3-100%) One case with PCP, who underwent to HIG scan after 2 weeks of therapy, was discordant. In 4 cases of IP a negative concordance was observed. All positive scans had an GS score grade IV and 99Tc-HIG SQI greater than 50% (56-93%). Negative scans had an GS score grade I or II and 99Tc-HIG SQI ratio less than 50% (31-44%). In 11 pts with other infections or tumors HIG scan was negative. No adverse reaction were observed. SQI ratio was significantly higher in PCP (64% + 17.2) than in normal pts (32% + 4.7). Moreover a significant linear correlation between SQI and arterial pO2 was found. Thus uptake of 99Tc-HIG and impairment of respiratory function seem to be related. CONCLUSION: HIG scan may be an useful tool for the study of PCP and bacterial abscesses in AIDS pts. The information content seems similar to that of GS with advantage of constant availability and fast response time (4 hours).
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Humans
- Immunoglobulins
- Lung
- Lymphoma
- Mycobacterium avium-intracellulare Infection
- Opportunistic Infections
- Pneumonia, Pneumocystis
- Sarcoma, Kaposi
- radionuclide imaging
Other ID:
UI: 102198584
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