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Rheumatology Advance Access originally published online on August 29, 2003
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Rheumatology 2004; 43: 195-201
© British Society for Rheumatology 2003; all rights reserved

Clinical

Expression of somatostatin receptors in inflammatory lesions and diagnostic value of somatostatin receptor scintigraphy in patients with ANCA-associated small vessel vasculitis

I. Neumann, S. Mirzaei1, R. Birck2, K. Osinger3, R. Waldherr4, H. D. Köhn1 and F. T. Meisl

Departments of Nephrology, 1Nuclear Medicine and 3Radiology, Wilhelminenspital, Vienna, Austria, 2Fifth Department of Medicine, University Hospital Mannheim, Germany and 4Institute of Pathology, Heidelberg, Germany.

Correspondence to: I. Neumann, Department of Nephrology, Wilhelminenspital, Montleartstr. 37, A-1171 Vienna, Austria. E-mail: irmgard.neumann{at}nep.wil.magwien.gv.at

Objective. To assess the usefulness of somatostatin receptor (SSTR) scintigraphy for the evaluation of disease activity in the upper and lower respiratory tract in ANCA-associated vasculitis (AASV).

Methods. Thirty-two consecutive patients with AASV were subjected to SSTR scintigraphy as part of their initial diagnostic evaluation and follow-up. The presence of SSTRs in inflammatory lesions was evaluated with immunohistochemistry in selected cases.

Results. In AASV, specificity of SSTR scintigraphy for active vs non-active disease was 96% for pulmonary disease and 100% for ear, nose and throat (ENT) involvement, while sensitivity was 86% and 68%, respectively. Absence of previously present tracer accumulation characterized treatment responders, and treatment resistance was reflected by repeated positive scintigraphy. We could demonstrate the expression of SSTRs in lung and mucosal biopsies obtained from patients with active Wegener's granulomatosis and with microscopic polyangiitis.

Conclusion. SSTR scintigraphy is useful for the assessment of AASV, indicating disease activity, disease extent and treatment efficacy. SSTRs are expressed in both granulomatous as well as non-granulomatous AASV.

KEY WORDS: Somatostatin receptor, Scintigraphy, ANCA, Vasculitis, Immunohistochemistry, Disease activity, Radiology, Lymphocytes, Pulmonary, ENT.


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