Noninvasive investigation of the gastrointestinal tract in collagen-vascular disease.

We have investigated the use of 111Indium granulocyte scanning, which would be expected to identify areas of perivascular or generalized neutrophil infiltration, in patients with collagen-vascular diseases suffering from either gastrointestinal symptoms (diarrhea or abdominal pain in 15 patients) or otherwise unexplained fever (six patients). Among patients with gastrointestinal symptoms, seven of 15 had positive scans suggesting large or small bowel involvement--three of three patients with Behcet's syndrome, four of five with vasculitis, no patient in six with systemic lupus erythematosus, and no patient with Churg-Strauss syndrome. Among patients without gastrointestinal symptoms, only one patient with polyarteritis nodosa had a positive scan, showing both large and small intestinal involvement. White cell scanning offers a noninvasive, readily tolerated technique for identifying inflammatory involvement of the intestine in patients with collagen-vascular disorders. Gastrointestinal involvement is rare in the absence of symptoms; and among symptomatic patients, inflammatory involvement of the gut is more likely to be found in patients with vasculitis or Behcet's.