Technetium99mTc-DTPA clearance in the evaluation of pulmonary involvement in patients with diabetes mellitus

Abstract

Systemic thickening of capillary endothelial basement membrane underlies the chronic complications of human diabetic microangiopathy. Since 99mTc-DTPA aerosol scintigraphy is a sensitive, non-invasive test of membrane permeability, we decided to study the effect of diabetes on the permeability of lung epithelium in diabetic patients using this test. Fifty (NIDDM) patients, aged 40-70 years, with or without complications, and who were non-smokers, were subjected to evaluation using 99mTc-DTPA aerosol. At the same time, pulmonary function tests, including carbon monoxide diffusion capacity, were done. Normal non-smoking subjects with no history of cardio-respiratory disease, who underwent 99mTc-DTPA and pulmonary function tests, served as controls. The risk factors which included age, sex, degree of control and presence of complications were noted. Twenty-nine (58%) of the patients had abnormal 99mTc-DTPA clearance. Thirty-four percent of the patients with complications and 24% of those without complications had abnormal clearance. Complications recorded included retinopathy, neuropathy and nephropathy. Fifty-five percent of patients with abnormal 99mTc-DTPA had suffered from diabetes for longer than 10 years. Sixty-two percent of patients with poor glycaemic control had abnormal 99mTc-DTPA. Diffusion capacity was not significantly affected in patients with complicated diabetes. Our preliminary results suggest that 99mTc-DTPA is a potentially sensitive test in assessing the degree of lung affection in diabetic patients. No significant correlation exists between diffusion capacity and 99mTc-DTPA. The risk factors did not affect the 99mTc-DTPA clearance, probably due to the small sample size.

Technetium 99m‐diethylene triamine penta‐acetic acid aerosol clearance in the evaluation of pulmonary involvement in sickle cell disease

“…Over 50% of our patients had delayed DTPA clearance similar to what was reported for diabetes mellitus (23), thus validating our hypothesis. While the number of diabetics with enhanced clearance was not reported by Mousa et al .…”

“…Values within the mean ± 1 SD of the laboratory values (61.5 ± 4 min) for healthy adult non‐smokers were considered normal (29). These were the same values used for the study on diabetic patients (23). Our normal control values are in agreement with those reported by Minty et al .…”

“…On the contrary, Mousa et al . (23) used DTPA clearance to investigate pulmonary involvement in adult diabetes mellitus patients and found that 58% had delayed clearance. This was attributed to the systemic thickening of the endothelial basement membrane from diabetic vasculopathy.…”

Assessment of alveolar epithelial permeability in Behçet’s disease with 99mTc-DTPA aerosol scintigraphy

“…The alveolar involvement may be the earliest pulmonary damage, and a non-invasive 99m Tc-DTPA clearance test can show the changes in pulmonary epithelial permeability that precedes clinical symptoms [16,17,19,20,21,24,27].…”

“…In this study, technetium-99m diethylene triamine penta-acetic acid ( 99m Tc-DTPA) aerosol inhalation scintigraphy, which is a simple, sensitive and non-invasive test commonly employed to assess the pulmonary epithelial membrane permeability was used to predict pulmonary alveolar epithelial damage in patients with BD [10][11][12][13][14][15][16][17][18][19][20][21][22].…”