Liver-Spleen Scanning in Pediatrics

PEDIATRICS ◽  
1974 ◽  
Vol 53 (5) ◽  
pp. 692-701
Author(s):  
Nancy Rosenfield ◽  
S. Treves
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Anatomical Variations ◽  
Healthy Children ◽  
Tumor Patients ◽  
Diffuse Liver Disease ◽  
Inflammatory Conditions ◽  
Abdominal Masses ◽  
Liver Scan ◽  
Iodine 131

Liver-spleen scans on 254 children were reviewed retrospectively with regard to accuracy and yield of the examination. The scan predicted abnormality correctly 95% of the time and normality correctly 86% of the time. Pitfalls in interpretation include the nonspecificity of abnormalities present on the scan, confusion of extrinsic with intrinsic defects, and normal anatomical variations with pathology. The technetium-99m-sulfur colloid scan was found to be most helpful in diagnosing splenic abnormalities, in working up abdominal masses, and in evaluating tumor patients after a baseline scan. It was found least useful in patients with fever of unknown origin, abdominal pain, diffuse liver disease, and most inflammatory conditions. Liver abscesses were not found in febrile, otherwise healthy children. The iodine-131-rose bengal liver scan was found to be useful to differentiate potentially curable lesions (e.g., choledochal cysts) from those not surgically treatable.

Liver Abscess in Normal Children With Fever of Unknown Origin

PEDIATRICS ◽  
1978 ◽  
Vol 61 (1) ◽  
pp. 148-148
Author(s):  
Henry H. Balfour
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Blood Cultures ◽  
Abscess Drainage ◽  
Normal Children ◽  
Liver Abscesses ◽  
History Of ◽  
Liver Scan ◽  
And Staphylococcus Aureus ◽  
Normal Immune Function

The article by Kaplan and Feigin (Pediatrics 58:614, October 1976) is a useful reminder that pyogenic liver abscesses do occur in children with normal immune function, and should be included in the differential diagnosis of fever of unknown origin. In both of their patients there was no history of abdominal trauma, blood cultures were sterile, the clinical diagnosis was confirmed by liver scan, and Staphylococcus aureus organisms were isolated from the abscess drainage at surgery.

scholarly journals LIPID PEROXIDATION AND OXIDATIVE PROTEIN PRODUCTS IN CHILDREN WITH EPISODIC FEVER OF UNKNOWN ORIGIN / LIPIDNA PEROKSIDACIJA I OKSIDATIVNI PROTEINSKI PRODUKTI KOD DECE SA EPIZODINOM GROZNICOM NEPOZNATOG UZROKA

2013 ◽  
Vol 33 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Jelena Radović ◽  
Jelena Vojinović ◽  
Vladmila Bojanić ◽  
Tatjana Jevtović-Stoimenov ◽  
Gordana Kocićs ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Fever Of Unknown Origin ◽  
Plasma Concentrations ◽  
Unknown Origin ◽  
Thiobarbituric Acid ◽  
Well Being ◽  
Oxidative Modification ◽  
Healthy Children ◽  
Oxidative Stress Biomarkers ◽  
Activated Neutrophils

Summary Background: Episodic fever syndromes are commonly seen in pediatric practice. Episodic fever of unknown origin (FUO) lasts for a few days or weeks and is followed by a fever-free period with a sense of well-being. In this condition, activated neutrophils and monocytes intensively generate reactive oxidative species that may further damage various mole- cules. The aim of the study was to evaluate oxidative stress biomarkers, lipid peroxidation in erythrocytes and plasma, and advanced oxidation protein products (AOPP) in children with episodic FUO. Methods: The study enrolled 25 children with episodic FUO in afebrile phase and 25 healthy children as controls. Lipid peroxidation was evaluated by measuring malondialdehyde (MDA) production with the thiobarbituric-acid-reactive sub- stances (TBARS) assay in erythrocytes and plasma. Oxidative modification of proteins was measured spectrophotometri- cally by the determination of AOPP in plasma. Results: Mean duration of episodic fevers was 3.96±2.8 years. Erythrocyte MDA levels were higher in children with FUO than in controls (86.26± 10.75 vs. 78.0±3.21 nmol/g hemoglobin), although not significantly (p=0.202). The MDA plasma concentrations were similar (2.42±0.35 vs. 2.41 ±0.39 (xmol/L) between the groups (p=0.732). Unexpectedly, levels of AOPP were significantly lower in chil- dren with FUO than in healthy controls (18.8±5.04 vs. 25.1 ±3.35 nmol/L, p=0.047). Conclusions: Episodic fevers of unknown origin with an aver- age duration of 3.96±2.8 years do not cause significant oxidative modifications of lipids and proteins in children.

Fever of unknown origin

2020 ◽  
pp. 664-669
Author(s):  
Steven Vanderschueren
Keyword(s):  
Rare Diseases ◽  
Broad Spectrum ◽  
Fever Of Unknown Origin ◽  
Febrile Illness ◽  
Unknown Origin ◽  
Clinical History ◽  
The Body ◽  
Initial Assessment ◽  
Drug Fever ◽  
Inflammatory Conditions

Fever of unknown origin refers to a prolonged febrile illness that persists without diagnosis after careful initial assessment. Although over 200 causes have been described, including rare diseases, most cases are due to familiar entities presenting in an atypical fashion. The ‘big three’ are infections, tumours, and multisystem inflammatory conditions. A miscellaneous category including factitious fever, habitual hyperthermia, and drug fever deserves consideration early in a patient’s workup, since timely recognition may avert invasive and expensive procedures. The clinician must rely on a very careful and thorough clinical history and examination that does not neglect any part of the body, followed by appropriately targeted investigations directed by knowledge of the broad spectrum of diseases and local epidemiology.

Patients with fever of unknown origin (FUO): diagnosis by nuclear medicine imaging

2001 ◽  
Vol 40 (03) ◽  
pp. 59-70 ◽  
Author(s):  
W. Becker ◽  
J. Meiler
Keyword(s):  
Nuclear Medicine ◽  
Fever Of Unknown Origin ◽  
Tumor Imaging ◽  
White Blood Cells ◽  
Unknown Origin ◽  
Final Diagnosis ◽  
Recurrent Fever ◽  
Nuclear Medicine Imaging

SummaryFever of unknown origin (FUO) in immunocompetent and non neutropenic patients is defined as recurrent fever of 38,3° C or greater, lasting 2-3 weeks or longer, and undiagnosed after 1 week of appropriate evaluation. The underlying diseases of FUO are numerous and infection accounts for only 20-40% of them. The majority of FUO-patients have autoimmunity and collagen vascular disease and neoplasm, which are responsible for about 50-60% of all cases. In this respect FOU in its classical definition is clearly separated from postoperative and neutropenic fever where inflammation and infection are more common. Although methods that use in-vitro or in-vivo labeled white blood cells (WBCs) have a high diagnostic accuracy in the detection and exclusion of granulocytic pathology, they are only of limited value in FUO-patients in establishing the final diagnosis due to the low prevalence of purulent processes in this collective. WBCs are more suited in evaluation of the focus in occult sepsis. Ga-67 citrate is the only commercially available gamma emitter which images acute, chronic, granulomatous and autoimmune inflammation and also various malignant diseases. Therefore Ga-67 citrate is currently considered to be the tracer of choice in the diagnostic work-up of FUO. The number of Ga-67-scans contributing to the final diagnosis was found to be higher outside Germany than it has been reported for labeled WBCs. F-l 8-2’-deoxy-2-fluoro-D-glucose (FDG) has been used extensively for tumor imaging with PET. Inflammatory processes accumulate the tracer by similar mechanisms. First results of FDG imaging demonstrated, that FDG may be superior to other nuclear medicine imaging modalities which may be explained by the preferable tracer kinetics of the small F-l 8-FDG molecule and by a better spatial resolution of coincidence imaging in comparison to a conventional gamma camera.

The Changing Etiology of Fever of Unknown Origin in Children

PEDIATRICS ◽  
2016 ◽  
Vol 137 (Supplement 3) ◽  
pp. 355A-355A
Author(s):  
James W. Antoon ◽  
David Peritz ◽  
Michael Parsons ◽  
Jacob Lohr
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin
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