Abstract |
Anterior abdominal scintigraphy after intravenous
injection of Tc-99m-human serum albumin (Tc-99m-HSA 20
mCi) was done in 16 patients with connective tissue
diseases and 15 healthy control patients. Patients with
proteinuria or hepatopathy were excluded. 1) 7(44%)
patients among 16 connective tissue disease patients
without the apparent evidence of external protein loss
showed abnormal intestinal accumulation of albumin. 6
patients with positive albumin scintigraphy showed
hypoalbuminemia. 2) There was no false positive
scintigraphic finding in control group. 3) The serum
albumin level in connective tissue disease patients
(3.1±0.6 g/dl, n=16) was lower than control
patients(3.9±0.3 g/dl, n=15) (p〈0.0001). 4) The serum
albumin level was lower in connective tissue disease
patients with positive Tc-99m-HSA scan(2.8±0.6 g/dl,
n=7) than the connective tissue disease patients with
negative scan(3.3±0.3 g/dl, n=9) (p〈0.05). 5) The
hemoglobin level in connective tissue disease patients
with positive scan(10.6±2.91 g/dl) was lower than that
of the control group (13.6±1.5 g/dl) (p〈0.05).
Hypoalbuminemia is frequently involved in chronic
connective tissue diseases. Protein losing
enteropathy(PLE) is also responsible for the majority
of the hypoalbuminemia in these patients, But it has
been ignored because the conventional method for the
diagnosis of PLE was difficult to difficult to perform.
Tc-99m-HSA scan also must be validated by more extended
study and comparison with the quantitative study such
as stool α-1 antitrypsin measurement. There must be a
reevaluation of PLE in various diseases especially in
connective tissue diseases with easy, fast, economical,
and noninvasive method. |