DIFFERENT ABDOMINAL SCINTIGRAPHY PATTERN IN PATIENTS WITH ULCERATIVE-COLITIS, CROHNS-DISEASE AND SERONEGATIVE SPONDYLARTHROPATHIES

The aim was to analyse the abdominal scintigraphy pattern in patients with seronegative spondylarthropathy (SSp), ulcerative colitis (UC) an d Crohn's disease (CD). A total of 117 patients with defined histologi cal lesions of inflammatory bowel disease (IBD) (68 UC and 49 CD), 32 patients with active SSp [European Spondylarthropathy Study Group (ESS G) 1991 criteria] without clinical evidence of IBD and 21 controls wit hout IBD or SSp were studied. All patients with SSp and controls recei ved similar doses of non-steroidal anti-inflammatory drugs. Abdominal scintigraphy images were obtained at 30 and 120 min after injection of 99m-technetium hexamethyl propylene amine oxime ((Tc-99m-HMPAO)-label led leucocytes. The Tc-99m-HMPAO-labelled leucocyte scan was positive in 17 patients with SSp (53.1%), 45 patients with UC (66.1%) and 33 pa tients with CD (67.3%). Rectum and sigma involvement was more frequent in patients with UC (68.8%) than in patients with SSp (23.5%) or CD ( 33.3%) (P < 0.05) [odds ratios (OR): 7.1 and 4.4, respectively]. Termi nal ileum involvement was more frequent in patients with CD (63.6%) th an in patients with SSp (23.5%) or UC (8.8%) (P < 0.05) (OR: 5.6 and 1 7.9, respectively). The Tc-99m-HMPAO-labelled leucocyte scan shows an increased uptake in patients with SSp without evidence of IBD. Perhaps these patients represent one end of the spectrum of IBD, but rectal a nd terminal ileum involvement were less frequent in patients with SSp than in patients with UC or CD.