Indian Journal of Nuclear Medicine
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CASE REPORT
Year : 2013  |  Volume : 28  |  Issue : 3  |  Page : 165-167

Abnormal extraosseous activity in both lungs and stomach in pre-transplant 99mTc-MDP bone scan disappearing after renal transplant


1 Department of Nuclear Medicine and PET, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, Maharashtra, India
2 Department of Nephrology, Bombay Hospital and Medical Research Centre, Marine Lines, Mumbai, Maharashtra, India

Correspondence Address:
Sunita Tarsarya Sonavane
Department of Nuclear Medicine and PET, Bombay Hospital and Medical Research Center, 12, Marine Lines, Mumbai - 400 020, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-3919.119549

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A chronic kidney disease male patient presenting with bone pains, fever, weakness, and clinically ascites was subjected to four technetium-99m-methylene diphosphonate (Tc99m-MDP) bone scans, two before renal transplant and two after renal transplants. Pretransplant bone scan revealed metabolic bone disease with focal insufficiency fractures. Marked extraosseous activity in both lungs and stomach was also visualized. On regular hemodialysis (HD) after 4 months, repeat pretransplant bone scan showed persistent uptake in lungs and stomach, representing altered calcium metabolism with microcalcifications. He underwent human leukocyte antigen (HLA) matched live donor renal transplantation, started on immune-suppression and steroids. Posttransplant bone scan at 20 days revealed no definite interval change, but bone scan performed approximately 17 months posttransplant showed resolving metabolic bone disease and the tracer uptake in the lungs and stomach was no more visualized. Patient clinically followed-up until the date (February 2013) is asymptomatic with serum creatinine of 1.5 mg/dl, no bone scan done.


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