Delayed gallium-67 uptake in renal atheroembolic disease

The differentiation between atheroembolic disease (AED) and allergic interstitial nephritis (AIN) may pose a clinical challenge. Gallium scans have been proposed to identify AIN with good discriminating ability. We report herein a case of atheroembolic disease presenting as acute renal failure with persistent delayed uptake of gallium-67 by nuclear imaging. The distinction between AED and AIN could be made only with a renal biopsy, which confirmed the correct diagnosis. This case report and the presented review of the literature suggest that gallium scans are nonspecific and should not supplant renal biopsy for definitive histological diagnosis.