RELATIVE SENSITIVITY OF TC-99M WBC VERSUS IN-111 WBC IN A PATIENT WITH CROHNS-DISEASE ON STEROIDS

Numerous studies have shown that chemotaxis is affected by certain ant ibiotics and steroids. A patient had Crohn's disease in relapse with m ultiple small bowel fistulae and mesenteric abscesses. Although the Tc -99m WBC scan did not show the intra-abdominal inflammatory foci, an I n-111 WBC scan performed within a week delineated the abscesses and th ese were later confirmed at surgery. This case is being presented not only to show the relative sensitivities of a Tc-99m WBC vs. an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear leuk ocyte chemotaxis by steroids, which may be a contributory factor to th e sensitivities of the different radiopharmaceuticals selected for det ection of intra-abdominal septic foci.