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Detection of alveolar epithelial injury by Tc-99m DTPA radioaerosol inhalation lung scan in rheumatoid arthritis patients

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Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disorder primarily involving the joints. Lung alterations in RA may be primary or secondary to pharmacological treatments and may involve the alveoli, interstitium, airways and/or pleura. Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA) aerosol inhalation scintigraphy is a sensitive and noninvasive test commonly employed to assess pulmonary epithelial membrane permeability. The purpose of the this study was a) to investigate the changes of pulmonary alveolar epithelial permeability in patients with RA, b) to determine the relationship between the clearance rate of Tc-99m DTPA and pulmonary function test (PFT) results, and c) to determine the relationship between the clearance rete of Tc-99m DTPA and clinical parameters of disease. Twenty-five patients with RA but without lung alterations were included in the study. The patients were 22 females, and 3 males; mean age 53.6 ± 8.7 years. Technetium-99m DTPA aerosol inhalation scintigraphy was performed on the study and healthy control groups. Clearance half times (T1/2) were calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was calculated on the first-minute image. There were no significant differences in the mean T1/2 or mean PI values between the RA patients and control subjects. No correlation was found between the mean T1/2 values of Tc-99m DTPA clearance and activity of RA, clinical values, or the spirometric measurements except FEV1/FVC and functional status in RA patients (p = 0.02, p = 0.01, respectively). However, a weak correlation was found between duration of disease and T1/2 values of Tc-99m DTPA clearance (p = 0.006). PI values tended to correlate with FEF25-75, although, this was not statistically significant (p = 0.057). This study shows that no changes occur in alveolar-capillary permeability in RA patients without lung alterations.

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Authors and Affiliations

  1. Nuclear Medicine Department, İstek Lojmanlan 19 Mayis Man. Hilmipaşa Cad., Uzay Sokak No: 10/7 Kozyataği-Kadiköy, İstanbul, Turkiye

    Berna Okudan & Feride Meltem Özbek

  2. Internal Medicine/Immunology Department, Suleyman Demirel University, School of Medicine, Isparta, Turkey

    Mehmet Şahİn & Erkan Cüre

  3. Biomedical Engineering Department, Yeditepe University, Istanbul, Turkey

    Ali Ümit Keskİn

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  1. Berna Okudan
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  2. Mehmet Şahİn
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  3. Feride Meltem Özbek
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  4. Ali Ümit Keskİn
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  5. Erkan Cüre
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Correspondence to Berna Okudan.

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Okudan, B., Şahİn, M., Özbek, F.M. et al. Detection of alveolar epithelial injury by Tc-99m DTPA radioaerosol inhalation lung scan in rheumatoid arthritis patients. Ann Nucl Med 19, 455–460 (2005). https://doi.org/10.1007/BF02985572

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  • DOI: https://doi.org/10.1007/BF02985572

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