ABSTRACT
OBJECTIVE: Wegener's granulomatosis (WG) is a relatively rare disease characterized by granulomatous necrotizing vasculitis that primarily involves small- and medium-sized vessels. Systemic findings observed on (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) have not been well reported. The purpose of this study was to evaluate the FDG PET/CT imaging in the diagnosis and follow-up of patients with WG. MATERIALS AND METHODS: Thirteen FDG PET/CT images obtained for 8 patients (2 men and 6 women) with WG were retrospectively analyzed. Of these, 6 were performed for diagnosis, 2 for restaging and follow-up, and 5 for assessment of treatment efficacy. Maximum standardized uptake values (max SUVs) and visual analyses were used to interpret the FDG PET/CT images. In addition, nonenhanced CT findings obtained during FDG PET/CT were described. RESULTS: WG lesions of the upper respiratory tract and lung were more clearly detected by FDG PET/CT fusion imaging than by nonenhanced CT alone, and all of the active lesions showed decreased FDG uptake after treatment. In addition, FDG PET/CT can provide complementary information to indicate biopsy site based on FDG uptakes. CONCLUSIONS: FDG PET/CT is a feasible modality for evaluating lesion activities, therapeutic monitoring, and follow-up of WG. Furthermore, biopsy sites of WG lesions may be determined by FDG PET/CT.
Subject(s)
Fluorodeoxyglucose F18 , Granulomatosis with Polyangiitis/diagnostic imaging , Multimodal Imaging , Positron-Emission Tomography , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Granulomatosis with Polyangiitis/therapy , Humans , Male , Middle Aged , Retrospective Studies , Treatment OutcomeSubject(s)
Graves Disease/complications , Hypertension, Pulmonary/etiology , Syncope/etiology , Aged , Amlodipine/administration & dosage , Atrial Fibrillation/diagnosis , Atrial Fibrillation/etiology , Digoxin/administration & dosage , Female , Graves Disease/diagnosis , Graves Disease/drug therapy , Humans , Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/drug therapy , Methimazole/administration & dosage , Recurrence , Syncope/drug therapy , Treatment Outcome , Vertigo/etiologySubject(s)
Antiviral Agents/administration & dosage , Betamethasone/administration & dosage , Glucocorticoids/administration & dosage , Hepatitis B, Chronic/drug therapy , Hepatitis C, Chronic/drug therapy , Lamivudine/administration & dosage , Prednisolone/administration & dosage , Acute Disease , Aged , Drug Therapy, Combination , Hepatitis B, Chronic/complications , Hepatitis C, Chronic/complications , Humans , MaleSubject(s)
Chemical and Drug Induced Liver Injury/etiology , Drugs, Chinese Herbal/adverse effects , Fenfluramine/adverse effects , Selective Serotonin Reuptake Inhibitors/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Diagnosis, Differential , Female , Hepatitis, Chronic/diagnosis , Humans , Middle AgedABSTRACT
We saw a patient with proteinuria and characteristics of lipoprotein glomerulopathy (LPG). Histologic analysis of renal biopsy showed a thrombus-like substance in the markedly dilated glomerular capillaries, which stained positive with oil red O. Increased concentration of plasma apolipoprotein E (apoE) was also noted. Those findings are consistent with the diagnostic criteria of LPG, as reported by Oikawa et al. In isoelectric focusing gel electrophoresis of apoE, a band (apoE3') between apoE3 and E2 was observed. The patient's DNA sequence exhibited a C to G substitution in exon 3 of the apoE gene at the position of the 25th amino acid, resulting in an amino acid substitution of the arginine residue for cysteine residue. To clarify the pathophysiologic role of this mutation, we investigated the binding and the uptake of apoE3' triglyceride-rich lipoproteins to human umbilical vein endothelial cells (HUVEC). The binding of apoE3'-triglyceride-rich lipoproteins to the cell-surface of HUVEC increased up to 30% to 50%, compared with apoE3-triglyceride-rich lipoproteins. But the uptake of apoE3'-triglyceride-rich lipoproteins into the cells was not different between them. These findings are consistent with the idea that an increase in binding of triglyceride-rich lipoproteins possessing apoE (Arg(25)-->Cys) to endothelial cells may promote deposition of lipid in the glomerular capillaries.
