Barai S, Bandopadhayaya G P, Rathi M, Singh N G
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
J Postgrad Med. 2005 Apr-Jun;51(2):119-21.
We describe a case of a 58-year-old male with longstanding hypertension and Type 2 diabetes mellitus who developed sudden onset renal impairment. The first clue to the possible presence of amyloidosis in this case was provided by the radionuclide renal cortical scan performed with trivalent dimercapto succinic acid (Tc99m-DMSA-3), which revealed intense tracer uptake in the spleen suggesting amyloid deposit. Further workup to ascertain the cause of amyloidosis led to the diagnosis of multiple myeloma. We conclude that in cases of extra-renal or splenic accumulation of Tc99m-DMSA-3, a diagnosis of amyloidosis should be considered, in an appropriate clinical setting.
我们描述了一例58岁男性患者，患有长期高血压和2型糖尿病，突发肾功能损害。该病例中可能存在淀粉样变性的首个线索是使用三价二巯基丁二酸（Tc99m-DMSA-3）进行的放射性核素肾皮质扫描，该扫描显示脾脏中有强烈的示踪剂摄取，提示淀粉样沉积物。进一步检查以确定淀粉样变性的病因，最终诊断为多发性骨髓瘤。我们得出结论，在Tc99m-DMSA-3在肾外或脾脏积聚的病例中，在适当的临床背景下应考虑淀粉样变性的诊断。
