| 特集名 | アミロイド骨・関節症 -- 診断と治療の実際 | |
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| 題名 | 診断 (4) RI標識アミロイド蛋白(131I，111In-β2-microglobulin)による核医学的診断 | |
| 発刊年月 | 1997年 08月 | |
| 著者 | 長谷川 伸 | 刈羽郡総合病院内科 |
| 著者 | 下条 文武 | 福井医科大学臨床検査医学教室 |
| 【 要旨 】 | 透析アミロイド症の診断における有用性を検討する目的で，131Iと111In-β2-microglobulinを用いたイメージングを，インフォームド・コンセントを得た血液透析と腹膜透析患者に対し試みた． 無菌的に核種を静注し，48時間後に全身をスキャンニングした．両者とも同様に，大きな関節に陽性で，疼痛または，X線上の所見を有し，アミロイド沈着が証明された関節だけでなく，所見のない関節にも集積した．また，核種静注後，早期に集積する症例を認めた．二次性副甲状腺機能亢進症，慢性関節リウマチによる続発性アミロイド症，偽痛風例では陰性であった． 同診断法は，透析アミロイド症の特異的診断法として，また活動性の指標として有用であった．治療効果の判定方法としても期待される． |
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| Theme | Amyloid-Related Bone and Joint Derangements -- Clinical Diagnosis and Treatment | |
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| Title | New diagnostic method of dialysis-related amyloidosis with imagings using 131I and 111In labeled beta2-microglobulin | |
| Author | Shin Hasegawa | Koseiren Kariwagun General Hospital |
| Author | Fumitake Gejyo | Fukui Medical School, Department of Clinical and Laboratory Science |
| [ Summary ] | New diagnostic imaging modalities using 131I or 111In labeled beta2-microglobulin (beta2-MG) were employed in patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis in order to study their utility in diagnosing dialysis-related amyloidosis (DRA). All participants understood the aim of this study and gave informed consent. The sterilized 131I and 111 In labeled beta2-MG preparations were given intravenously. At 48 hours after the injection, whole body imaging was performed in all patients. Positive images using both tracers were obtained, in the same way, at large joints (shoulders, elbows, wrists, hips, knees and ankles) in patients with biopsy proven amyloid. Furthermore, the images were positive at not only joints in which the patients felt pain or had positive findings on x-ray examinations and in whom amylofd deposits were proved, but also at joints in which they did not. In some patients, positive images were revealed shortly after injection. Negative images were obtained in patients who had secondary hyperparathyroidism, secondary amyloidosis due to rheumatoid arthritis and pseudogout. Imaging using 131I or lll In labeled beta2-MG is potentially useful for diagnosing and estimating the activity indices of DRA, as well as for evaluating the effectiveness of DRA treatment. |
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