All are used to diagnose protein losing enteropathy except:
D i.e. Tc seclosumab & Tc Fab - 99mTcantimyosin Fab fragments are specific markers of myocyte damageQ with a sensitivity of 95%. It is taken up only in acute infarct with decreasing intensity as the infarct heals. - Infarct avid imaging (hot spot imaging) of myocardial infarction, uses radionuclide agents such as 99mTcpyrophosphate (standard), 99mTctetracycline, 99mTc-glucoheptonate, 99MTCantimyosin Fab fragment, 203Hgchlormerodrin, 18F- sodium fluoride, 111Indium antimyosin (murine monoclonal antibodies to myosin). - 201Thallium chloride used for nonavid infarct imaging (cold spot imaging) is the radionuclide agent of choice to assess myocardial bility and to study myocardial perfusion for acute MI. 201T1uptake depends on quality of regional perfusion and bility of myocardial cells with cellular integrity of Na/K pump. So it is used in coronary aery disease & acute MI. Cold defects at rest may represent transient ischemia in unstable angina. However, it cannot distinguish between recent & remote infarction. Protein losing enteropathy is a group of gastrointestinal & non gastrointestinal disorders with excessive protein loss into the gi tract resulting in hypoproteinemia & edema in absence of either proteinuria or defect in protein synthesis (eg liver cirrhosis). The protein loss into git may be due to? 1- Exudation through ulcerative lesion eg UC, gi carcinoma & peptic ulcers; 2- Altered permeabitily through nonulcerated mucosa eg menetrier's disease and ; 3- Lymphatic dysfunction eg d/t enlarged lymph node or primary lymphatic disease. The diagnosis is suggested by peripheral edema, low serum albumin & globulin leves (both), in absence of kidney & liver disease (selective loss almost excludes the diagnosis). Relative lymphopenia (d/t loss of lymphocytes lymphatics) may also occur. Protein loss in GIT is documented and established by administration of radionuclide labeled proteins and its quantification in stools during a 24-or 48-hr period. Radionuclides that are tried include 1111ndium (In) chloride, 1111n-transferrin 99mTc-albumin (HSA = human serum albumin), 99mTchuman immunoglobulin, 99MTCdextran, 1311polyvinyl pyrrolidone, 125Ipolyvinyl pyrrolidone,125I albumin, 51Cr chromic chloride, 51Cr-albumin and a-1 antitrypsin clearance. Broadly you can remember that albumin, dextran, transferrin and ar antitrypsin (all proteins) lobelled with 99m-rc /min/ 1251 /1311 51Crare used to detect protein losing enteropathy.
Tc albumin
Tc dentran
In-transferrin
Tc-seclosumab & Tc Fab