교원병에 동반된 단백소실장질환 ( Protein Losing Enteropathy ) 에서의 테크네슘표지 인혈청알부민 스캔 = Diagnosis of Protein Losing Enteropathy in connective Tissue Diseases with 99mTc - human Serum Albumin ( HSA )

다국어 초록 (Multilingual Abstract)

Anterior abdominal scintigraphy after intravenous injection of Tc-99m-human serum albumin (Tc-99m-HSA 20 mCi) was done in 16 patients with connective tissue diseases and 15 healthy control patients. Patients with proteinuria or hepatopathy were excluded. 1) 7(44%) patients among 16 connective tissue disease patients without the apparent evidence of external protein loss showed abnormal intestinal accumulation of albumin. 6 patients with positive albumin scintigraphy showed hypoalbuminemia. 2) There was no false positive scintigraphic finding in control group. 3) The serum albumin level in connective tissue disease patients (3.1±0.6 g/dl, n=16) was lower than control patients(3.9±0.3 g/dl, n=15) (p〈0.0001). 4) The serum albumin level was lower in connective tissue disease patients with positive Tc-99m-HSA scan(2.8±0.6 g/dl, n=7) than the connective tissue disease patients with negative scan(3.3±0.3 g/dl, n=9) (p〈0.05). 5) The hemoglobin level in connective tissue disease patients with positive scan(10.6±2.91 g/dl) was lower than that of the control group (13.6±1.5 g/dl) (p〈0.05). Hypoalbuminemia is frequently involved in chronic connective tissue diseases. Protein losing enteropathy(PLE) is also responsible for the majority of the hypoalbuminemia in these patients, But it has been ignored because the conventional method for the diagnosis of PLE was difficult to difficult to perform. Tc-99m-HSA scan also must be validated by more extended study and comparison with the quantitative study such as stool α-1 antitrypsin measurement. There must be a reevaluation of PLE in various diseases especially in connective tissue diseases with easy, fast, economical, and noninvasive method.