Flipo R M, Deveaux M, Duneton O, Foissac-Gegoux P, Dumont A, Duquesnoy B, Marchandise X
Service de rhumatologie (Pr B. Delcambre), Höpital B. CHRU Lille.
Nephrologie. 1995;16(6):419-25.
To assess the iodine-123-labelled serum amyloid P component (SAP) scintigraphy in patients with haemodialysis-associated amyloidosis.
Eight patients with histologically proven beta 2-microglobulin amyloidosis.
Purified SAP was iodinated by a modified iodogen method. Whole body data were acquired with a large rectangular field gamma-camera.
In 7 cases, articular uptake was observed in the symptomatic joints (shoulders, wrists, knees) or in view of bone cysts (wrists). Among the 3 patients with erosive arthropathy of the hands, only one had positive scintigraphy. None positive scintigraphic image was obtained in the spine or the hip joint. In one patient with multifocal amyloid joint disease, no positive image was noted. No abnormal visceral uptake was observed and particularly of the spleen except in one patient with liver uptake.
I-123 SAP scintigraphy might be not very sensitive in diagnosing beta 2 amyloid deposits. This method needs further investigations and particularly in patients undergoing haemodialysis for more than 20 years.
评估碘-123标记的血清淀粉样蛋白P成分（SAP）闪烁扫描术在血液透析相关性淀粉样变患者中的应用。
8例经组织学证实为β2-微球蛋白淀粉样变的患者。
采用改良碘原法对纯化的SAP进行碘化。使用大型矩形视野γ相机采集全身数据。
7例患者在有症状的关节（肩部、腕部、膝部）或鉴于骨囊肿（腕部）处观察到关节摄取。在3例手部侵蚀性关节病患者中，只有1例闪烁扫描呈阳性。在脊柱或髋关节未获得阳性闪烁扫描图像。1例多灶性淀粉样关节病患者未观察到阳性图像。除1例肝脏摄取的患者外，未观察到异常的内脏摄取，尤其是脾脏。
I-123 SAP闪烁扫描术在诊断β2淀粉样蛋白沉积方面可能不太敏感。该方法需要进一步研究，特别是在接受血液透析超过20年的患者中。
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