Article
99mTc-HMPAO leucocyte scintigraphy fails to detect
Crohn's disease in the proximal gastrointestinal tract
S M Davisona, S Chapmanb, M S Murphya
a Department of
Gastroenterology, Birmingham Children's Hospital and Institute of
Child Health, University of Birmingham, Clinical Research Block,
Whittall Street, Birmingham B4 6NH, UK, b Department of Radiology,
Birmingham Children's Hospital
Correspondence to: Dr Murphy m.s.murphy{at}bham.ac.uk
Accepted 20 February
2001
OBJECTIVE
To
investigate the use of 99mTc-HMPAO (hexamethyl propylene
amine oxime) leucocyte scintigraphy as a non-invasive screening test for inflammatory bowel disease.
PATIENTS10 children
with suspected Crohn's disease, in whom routine investigation using
barium contrast radiology, upper gastrointestinal endoscopy,
colonoscopy, and mucosal biopsies had identified severe gastroduodenal
and/or jejunal involvement.
DESIGN99mTc-HMPAO
leucocyte scintigraphic studies performed in each of these cases were
assessed by a radiologist who was blinded to the disease distribution.
RESULTSIn nine cases
there was no scintigraphic evidence of inflammation in the proximal
gastrointestinal tract. The 10th child had both gastroduodenal and
jejunal involvement, but scintigraphy only revealed faint jejunal positivity.
CONCLUSIONS99mTc-HMPAO
leucocyte scintigraphy should not be depended upon as a screening test
for Crohn's disease. False negative results are likely in cases with
Crohn's disease confined to the proximal gastrointestinal tract.
Keywords: inflammatory bowel disease; Crohn's disease; 99mTc-HMPAO; scintigraphy
© 2001 by Archives of Disease in Childhood
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