ABSTRACT
El [131I]Iodo-6-Beta-iodometil-19-norcolesterol ([131I]Norcolesterol), radiofármaco indicado en el diagnóstico del estado funcional de tejido cortical suprarrenal, en la detección del tejido funcional en el hiperadrenocorticalismo así como en el aldosteronismo primario. Presentamos el caso de una mujer de 54 años de edad, remitida para la evaluación de una sospecha de aldosteronismo, y que inmediatamente después de la administración intravenosa de [131I]Norcolesterol sufrió una fuerte reacción adversa al medicamento, con mareo, rubor, aumento de la presión arterial, opresión en el pecho, dolor lumbar y sarpullido eritematoso hasta 9 días postinyección. Los síntomas se resolvieron satisfactoriamente tras la administración de antihistamínicos y corticoides. Se sospechó que esta reacción estuviera relacionada con la administración del [131I]Norcolesterol causada por una reacción alérgica de tipo I (AU)
The [131I]Iodine-6-Beta-iodomethyl-19-norcholesterol ([131I]Norcholesterol; NP-59), is indicated in the diagnosis of the functional state of adrenal cortical tissue, in the detection of functional tissue in hyperadrenocorticalism as well as in primary aldosteronism. We present the case of a 54-year-old woman, referred for evaluation of suspected aldosteronism, and who immediately after intravenous administration of [131I]Norcholesterol suffered a strong adverse drug reaction, with dizziness, flushing, increased blood pressure, chest tightness, low back pain and erythematous rash up to 9 days after injection. Symptoms resolved satisfactorily after administration of antihistamines and corticosteroids. This reaction was suspected to be related to the administration of [131I]Norcholesterol caused by a type I allergic reaction.(AU)
Subject(s)
Humans , Female , Middle Aged , Low Back Pain/chemically induced , Adosterol/adverse effects , Radiopharmaceuticals/adverse effects , Radionuclide ImagingABSTRACT
NP-59 concentrates in steroid hormone synthesizing tissues, enabling scintigraphic localization and characterization of endocrine dysfunction in the adrenal cortex and ovary. Studying 108 consecutive cases from 1982 to 1985 and using clinical, biochemical, radiographic, and pathologic data, we performed a rigorous assessment of the accuracy and pitfalls of NP-59 scintigraphy. The evaluation was divided into categories of abnormal hormone secretion: Cushing's syndrome, primary aldosteronism, and hyperandrogenism. Additional categories included euadrenal tumors (without detectable hormone dysfunction) and sites of residual adrenal cortical tissue. The accuracy of NP-59 scintigraphy ranged from 71% in primary aldosteronism and 75% in euadrenal tumors, to 100% for Cushing's syndrome and hyperandrogenism. However, more than in most nuclear medicine studies, NP-59 imaging requires well-defined indications to be met for it to be efficacious, including the fulfillment of clear clinical, biochemical, and radiographic criteria. The high reproducibility of NP-59 scintigraphic interpretation was demonstrated when 40 random cases underwent interinstitutional exchange and through interobserver evaluation at the University of Michigan. Responses of 85/126 medical centers to questionnaires revealed the high level of NP-59 safety.
