Falsely Negative ^99mTc-Antigranulocyte Immunoscintigraphy and Positive ^99mTc-HMPAO-La be I led Leukocyte Scan in Active Crohn’s Disease

Summary

A 19-year-old woman with active Crohn’s disease under immunosuppressive therapy underwent scintigraphy with ^99mTc-anti-NCA-95 antigranulocyte antibodies in order to determine the extent of inflammation. It turned out to be falsely negative whereas a ^99mTc-HMPAO-labelled leukocyte scan revealed a marked terminal ileitis and pancolitis. It is assumed that immunosuppressive therapy was the main reason for the falsely negative antibody scan, possibly affecting the red bone marrow where most of the antibodies bind to granulocytes. Peripheral leukocytes labelled in vitro do not seem to be subject to these hypothetical effects on red bone marrow.

Zusammenfassung

Bei einer 19jährigen Frau mit aktivem M. Crohn unter immunsuppressiver Therapie wurde eine Immunentzündungsszintigraphie mit dem ^99mTc-Anti-NCA-95-Antigranulozytenantikörper durchgeführt, um das Ausmaß der Entzündung zu erfassen. Die Immunentzündungsszintigraphie fiel falsch-negativ aus, während eine Szintigraphie mit ^99mTc-HMPAO-markierten Leukozyten eine ausgeprägte terminale Ileitis und Pankolitis erkennen ließ. Es wird vermutet, daß die immun-suppressive Therapie die Hauptursache für die falsch-negative Antikörperszinti-graphie war, möglicherweise über eine Wirkung auf das rote Knochenmark, wo sich der größte Teil der Antikörper an die Granulozyten bindet. In vitro markierte periphere Leukozyten scheinen diesen hypothetischen Effekten auf das rote Knochenmark nicht zu unterliegen.

Keywords

Antigranulocyte immunoscintigraphy - labelled leukocytes - Crohn’s disease - immunosuppression

Schlüsselwörter

Antigranulozyten-lmmunszintigraphie - markierte Leukozyten - M. Crohn - Immunsuppression

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