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Oktreotidszintigraphie zur Diagnose der aktiven endokrinen Orbitopathie

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Zusammenfassung

Hintergrund

Überprüft wurde die diagnostische Aussagekraft der Oktreotidszintigraphie bei Verdacht auf aktive endokrine Orbitopathie.

Patienten und Methodik

Eine prospektive Studie an 23 Patienten mit endokriner Orbitopathie wurde durchgeführt. Vier Stunden nach intravenöser Gabe von 3 mCi 111 Indium Oktreotid wurden SPECT-Aufnahmen durchgeführt. Die Resultate wurden während einer Nachbeobachtungsperiode von 17±6 Monaten mit dem klinischen Zustand der Patienten korreliert.

Ergebnisse

Die Oktreotidszintigraphie war in 15 Fällen pathologisch positiv und in 8 Fällen negativ. Zwölf Patienten mit positiver Oktreotidszintigraphie unterzogen sich erfolgreich einer immunsuppressiven Behandlung mit Zeichen der Regression. In 3 Fällen verweigerten die Patienten eine immunsuppressive Behandlung. Patienten ohne pathologische Oktreotidaufnahme unterzogen sich keiner Behandlung.

Schlussfolgerung

Oktreotidszintigraphie stellt eine diagnostische Hilfe zur Beurteilung einer endokrinen Orbitopathie dar. Da diese im akuten Stadium behandelt werden muss, sollte eine Oktreotidszintigraphie bei subakuten Fällen durchgeführt werden, um die Indikationsstellung einer immunsuppressiven Behandlung zu vereinfachen.

Abstract

Purpose

In this study the diagnostic accuracy of orbital octreotide uptake in patients with presumed active Grave's ophthalmopathy (GO) was evaluated.

Patients and methods

A prospective study of 23 patients suffering from GO was carried out. Single photon emission computed tomography (SPECT) images were obtained 4 h after iv injection of 3 mCi 111 indium octreotide. The results were correlated with the patients clinical state during a follow-up of 17.5±6 months.

Results

Octreotide scintigraphy was positive in 15 and negative in 8 cases, 12 patients with positive octreotide scintigraphy underwent immunosuppressive treatment and showed a clinically positive response with regression of symptoms. In three cases the patients refused immunosuppressive treatment. Patients with negative pathologic orbital octreotide uptake did not undergo any treatment.

Conclusion

Octreotide scintigraphy is a useful tool to determine the activity state of Graves' ophthalmopathy. Since Graves' ophthalmopathy must be treated in the active phase, octreotide scintigraphy should be performed in subacute cases to facilitate the indications for immunosuppressive treatment.

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Authors and Affiliations

  1. Universitäts-Augenklinik, Karl Franzens Universität Graz

    N. Ardjomand, G. Esche, P. Fellner, S. Lindner, M. Panzitt & A. Langmann

  2. Abteilung für Nuklearmedizin der Universitätsklinik für Radiologie, Karl Franzens Universität Graz

    R. Aigner

  3. Universitätsaugenklinik der Karl Franzens Universität, Auerbruggerplatz 4, 8036 , Graz, Österreich

    N. Ardjomand

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  1. N. Ardjomand
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  2. G. Esche
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  3. P. Fellner
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  4. S. Lindner
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Correspondence to N. Ardjomand.

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Ardjomand, N., Esche, G., Fellner, P. et al. Oktreotidszintigraphie zur Diagnose der aktiven endokrinen Orbitopathie. Ophthalmologe 100, 1049–1053 (2003). https://doi.org/10.1007/s00347-003-0807-1

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  • DOI: https://doi.org/10.1007/s00347-003-0807-1

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