Liver function evaluation in leptospirosis with colloidal gold 1 9 8 Au

Abstract

Eigh t patients with leptospirosis were studied with colloidal gold 19 sAu. The radiocolloidal hepatic distribution was altered, presenting a non-homogeneous tiver concentration in seven cases, and a minute to moderate splenic visualization in five. Two patients presented d ou b tfu i splenic image, and one seemed to be normal. Liver scanning wi th colloidal gold 19&A u is demonstra ted to be a good liver function test. IN T R O D U C T IO NThe Nuclear Medicine Tests have become more and more valuable to observe the metabolic and functional processes in man. Various radioactive compounds have been used for the detection of abnormalities in the liver (Table I). Among them, the most commonly employed are the Rose Bengal 131l, the colloidal gold 198Au and the suifur colloid 99mTc. The first one has been mainly applied to evaluate the hepatocyte function and the biliary tract, as an excretíon test. In pediatrics, it has a great value in the investigation of neotal jaundice14. It enters and leaves the polygonal cells by the active transport mecanism. Because of the physical caracteristics o f the 123l, Rose Bengal 12 31 has been demonstrated to be an ideal radiocompound1 °. The last two agents give the physician Science about the normality of the reticuloendothelial system. They principally deposit in the liver by phagocytosis through the Kupffer cells. Griffiths5 stated that the sulfúr colloid 99mTc does not, as it was thought, come through the Kupffer cells by phagocytosis, but stays in their membrane . Other organs also concentrate these radioactive particals the same way as in the liver, but in very minute amount. Those organs are the spleen, the bone marrow, the lymph nodes and other magrophages.It seems that the colloidal gold 198Au is a better agent to study diffuse liver diseases than the suifur colloid " mTc, and that this one helps the physician note space occupying lesions more accurately than the colloidal gold 198Au. There are two important pdvantages of the sulfúr colloid 99mTc over the radioactive colloidal gold: a) -its short half-life (T 1/2 = 6 hr.) and weak energy. (140 kev) make the patient recieve a lower radiation dose;