Scintigraphic Evaluation Of Kidney •Functions In Systemic Lupus E1ythematosus

Abstract

Syst mic lupus erythematosus is <Ill inll<Hnlllatory mult.is\•stcmic disc•asc• or unknown etiology. characterized by a wide variety or clinical presentations especially lupus nephritis. and the prcsem:c ol'nmltiplc autoantibodies.

lupus morbidity. Over diagnosis may result in exposure to polL•ntially toxic medications. lailure to initiate correct intcrwntion. and negative psychological effects on the patients.

Lupus nephritis is diagnosed by renal biopsy. the less invasive as renal ultrasonography & renal laborat01y investigations are unable to replace renal biopsy. Nuclear medicine has some currently available techniques which might be able to meet these requirements, we have used Tc scanning with DMSA & DTPA and COITelate our results with clinical and radiological measurements of renal activity

We have li.llind that dynamic renal scanning with Tc-DTI'A is hclpl'ul in detection of moderate and severe grade of lupus nq'lhritis. Also it can be a good method in monitoring renal status in follow up studies.

On the other hand as regards Tc-DMSA scanning. although it detected morphology of the kidneys similar to ultrasound, but it f[tilcd to detect early tubular changes, that lead us to the tact that the cheaper and safer abdominal ultrasonography gives faster and the . same accurate results as regards morphology. Although dynamic Tc-DTPA scanning may have a role in diagnosis of lupus nephritis, however it doesn't exclude the need l(x renal biopsy or other laboratory investigations, and it is better to be •Ltsed in the li.lHow up oflupus nephritis ratlJL•r th<tn in its detection.