Abstract
An 18-year-old woman reported that after exposure to cold temperatures her fingers appeared blue and her hands and feet felt cold. Secondary Raynaud’s phenomenon (RP) associated with peripheral vascular disease was suspected. Technetium (Tc)-99m-labeled RBC hand scintigraphy after cold change showed decreased blood pool activity in her fingers. The patient’s symptoms improved after she received sarpogrelate HCL (200 mg/day) and nifedifine (40 mg/day). Follow-up scintigraphy performed 7 months after the patient started treatment showed paradoxically increased blood pool activity in her fingers after cold challenge. To the best of our knowledge, this is the first case report of a patient with secondary RP showing paradoxical change on scintigraphy after she received medication that improved her symptoms.
References
Goundry B, Bell L, Langtree M, Moorthy A. Diagnosis and management of Raynaud’s phenomenon. BMJ. 2012;344:e289.
Bang SH, Oh YS, Park HJ, Lee TK, Yang JS, Lee SM, et al. Evaluation of finger blood flow with Tc-99m MDP (methylene diphosphonate). Korean J Intern Med. 1992;7(2):94–101.
Kwon SR, Lim MJ, Park SG, Hyun IY, Park W. Diagnosis of Raynaud’s phenomenon by (99m)Tc-hydroxymethylene diphosphonate digital blood flow scintigraphy after one-hand chilling. J Rheumatol. 2009;36(8):1663–70.
Lee JW, Jeong WS, Lee SM, Kim J. Comparison of the diagnostic performances of two protocols of hand perfusion scintigraphy for Raynaud’s phenomenon. Nucl Med Commun. 2012;33(10):1032–8.
Lim S, Chung J, Lee M, Kim S, Choi S, Koh C. Korean J Nucl Med. 1987;21:183–8.
Sarikaya A, Ege T, Firat MF, Duran E. Assessment of digital ischaemia and evaluation of response to therapy by 99mTc sestamibi limb scintigraphy after local cooling of the hands in patients with vasospastic Raynaud’s syndrome. Nucl Med Commun. 2004;25(2):207–11.
Herrick AL. The pathogenesis, diagnosis and treatment of Raynaud phenomenon. Nat Rev Rheumatol. 2012;8(8):469–79.
Barreira RI, Garcia BB, Lopez MG, Legazpi IR, Diaz HA, Penin IR. Paradoxical reaction of raynaud phenomenon following the repeated administration of iloprost in a patient with diffuse cutaneous systemic sclerosis. Ann Pharmacother. 2012;46(10):e28.
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Chong, A., Ha, JM., Song, HC. et al. Conversion to Paradoxical Finding on Technetium-99m-labeled RBC Scintigraphy after Treatment for Secondary Raynaud’s Phenomenon. Nucl Med Mol Imaging 47, 278–280 (2013). https://doi.org/10.1007/s13139-013-0215-7
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DOI: https://doi.org/10.1007/s13139-013-0215-7