Clinical significance of abdominal scintigraphy using Tc-99m-HMPAO-labelled leucocytes in patients with seronegative spondyloarthropathies

Abdominal scintigraphy shows silent gut inflammation in patients with spond yloarthropathies (Sp) without clinical evidence of gut inflammation. Abdomi nal scintigraphy images ate different than those obtained in patients with ulcerative colitis or Crohn's disease and are not related to the anti-infla mmatory drugs administered. The aim of this study was to examine the clinic al associations of findings on abdominal scintigraphy in patients with Sp. A total of 204 Sp patients (European Spondylarthropathy Study Group 1991 cr iteria) and 54 non-Sp controls receiving non-steroidal anti-inflammatory dr ugs were studied. Abdominal scintigraphy images were obtained at 30 and 120 min after injection of technetium-99m hexamethylpropylene amine oxime (Tc- 99m-HMPAO)-labelled leucocytes. Tc-99m-HMPAO-labelled leucocyte scans were positive in 104 Sp patients (50.9%) and in six non-Sp controls (2.9%) (P < 0.001; OR = 8.32; 95% CI = 3.23-22.67). Silent gut inflammation was not ass ociated with any of the following: age of onset, duration of evolution, sex , family history of Sp or psoriasis, articular manifestations, extraarticul ar manifestations, radiological findings or HLA-B27 positivity. Positive ab dominal scintigraphy was associated with active disease (P < 0.0001; OR = 5 2.7; 95% CI = 19-145.6) and an increase in the C-reactive protein (P < 0.00 5; OR = 3.4; 95% CI = 1.5-7.4). It is concluded that (a) abdominal scintigr aphy using Tc-99m-HMPAO-labelled leucocytes is of value in detecting the si lent gut inflammation in Sp patients, and (b) silent gut inflammation is re lated to the clinical activity, but is not associated with any particular t ype of illness or with HLA-B27.