Expression of somatostatin receptors in inflammatory lesions and diagnostic value of somatostatin receptor scintigraphy in patients with ANCA-associated small vessel vasculitis

• Published in: Rheumatology (Oxford, England) Vol. 43; no. 2; pp. 195 - 201
• Main Authors: Neumann, I., Mirzaei, S., Birck, R., Osinger, K., Waldherr, R., Köhn, H. D., Meisl, F. T.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.02.2004; Oxford Publishing Limited (England)
• Subjects: Adult; Aged; Aged, 80 and over; ANCA; Antibodies, Antineutrophil Cytoplasmic - blood; Biological and medical sciences; Biomarkers - blood; Disease activity; Diseases of the osteoarticular system; ENT; Female; Granulomatosis with Polyangiitis - diagnostic imaging; Granulomatosis with Polyangiitis - metabolism; Humans; Immunohistochemistry; Lung Diseases - diagnostic imaging; Lung Diseases - metabolism; Lymphocytes; Male; Medical sciences; Middle Aged; Otorhinolaryngologic Diseases - diagnostic imaging; Otorhinolaryngologic Diseases - metabolism; Pulmonary; Radiology; Radionuclide Imaging; Receptors, Somatostatin - metabolism; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Scintigraphy; Sensitivity and Specificity; Somatostatin - analogs & derivatives; Somatostatin receptor; Vasculitis; Vasculitis - diagnostic imaging; Vasculitis - metabolism; Radionuclide study; Immunohistochemistry; Antineutrophil cytoplasmic antibody; Disease; Lung; Peptide hormone; Cardiovascular disease; Activity; ENT; Scintigraphy; Vascular disease; Association; Vasculitis; ANCA; Lymphocytes; Blood vessel; Diagnosis; Somatostatin; Human; Small; Disease activity; Somatostatin receptor; Rheumatology; Inflammation; Anatomic pathology; Radiology; Value; Medical imagery; Lesion; Lymphocyte; Pulmonary
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/keg479

Objective. To assess the usefulness of somatostatin receptor (SSTR) scintigraphy for the evaluation of disease activity in the upper and lower respiratory tract in ANCA-associated vasculitis (AASV). Methods. Thirty-two consecutive patients with AASV were subjected to SSTR scintigraphy as part of their initial diagnostic evaluation and follow-up. The presence of SSTRs in inflammatory lesions was evaluated with immunohistochemistry in selected cases. Results. In AASV, specificity of SSTR scintigraphy for active vs non-active disease was 96% for pulmonary disease and 100% for ear, nose and throat (ENT) involvement, while sensitivity was 86% and 68%, respectively. Absence of previously present tracer accumulation characterized treatment responders, and treatment resistance was reflected by repeated positive scintigraphy. We could demonstrate the expression of SSTRs in lung and mucosal biopsies obtained from patients with active Wegener's granulomatosis and with microscopic polyangiitis. Conclusion. SSTR scintigraphy is useful for the assessment of AASV, indicating disease activity, disease extent and treatment efficacy. SSTRs are expressed in both granulomatous as well as non-granulomatous AASV.