TC-99M-WHITE CELL SCANNING TO DETECT GUT INFLAMMATION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASES OR SPONDYLOARTHROPATHIES

Objective Gut inflammation is a common feature shared by inflammatory bowel diseases (IBD) and the spondyloarthropathies (SpA). The aim of t he present study was to compare the reliability of a number of non-inv asive investigations for the detection of an inflammatory process of t he intestine Methods Forty-two children were studied: (i) patients wit h a previous diagnosis of IBD (group A); (ii) patients with suspected IBD (group B); and (iii) patients with predominantly rheumatological m anifestations associated with gastrointestinal symptoms (group C). All the patients were studied using (99m)Technetium-HMPAO labelled white cell scanning (Tc-99m-WCS), and abdominal ultrasound (US). In addition the ESR, ser um class A immunoglobulins, faecal occult blood (OB) and faecal alpha 1-antitripsin level (F alpha 1-AT) were determined Colon oscopy plus multiple biopsies and radiological study of the intestine were used as gold standards. Results Tc-99m-WCS showed the highest sen sitivity (85%) and specificity (100%) in detecting the presence of gut inflammation. This was followed by ESR and faecal occult blood (63% s ensitivity, 44% specificity), F alpha 1-AT (43% sensitivity, 44% speci ficity) and IgA (42% sensitivity, 88% specificity). Ultrasound was inf ormative in 28% of the active/affected patients, with a specificity of 75%. Conclusion Although ileo-pancolonscopy remains the gold standard for the histological characterisation of gut inflammation, Tc-99m-WCS represents the most reliable non-invasive test for its detection.