Tc-99m HMPAO labeled white blood cell imaging in a child with eosinophilic lung disease

Area of Science:

• Nuclear medicine
• Radiopharmacology
• Pulmonary medicine

Background:

• Technetium-99m HMPAO (hexamethylpropylene amine oxime) labeled leukocyte imaging is used for infection detection.
• Tc-99m HMPAO demonstrates higher affinity for eosinophils than neutrophils.
• This characteristic may be valuable in diagnosing conditions with eosinophilic infiltration.

Observation:

• A case study of a 2-year-old boy with sepsis and suspected drug-induced eosinophilic lung disease is presented.
• During sepsis investigation, diffuse pulmonary uptake of Tc-99m HMPAO labeled leukocytes was observed.
• Diagnosis of eosinophilic lung disease was later confirmed by bronchoalveolar lavage and cessation of the offending antibiotic.

Findings:

• The observed diffuse pulmonary accumulation of labeled leukocytes in the patient was consistent with eosinophilic lung infiltration.
• This imaging finding, in the context of infection, suggests Tc-99m HMPAO's utility in identifying eosinophilic processes.
• The study highlights the potential for Tc-99m HMPAO scans to indicate eosinophilic lung disease.

Implications:

• Tc-99m HMPAO labeled leukocyte imaging may serve as a non-invasive tool for detecting eosinophilic lung infiltration.
• Integrating imaging findings with clinical and laboratory data is essential for accurate interpretation of Tc-99m HMPAO scans.
• This case underscores the importance of considering drug-induced lung injury in pediatric sepsis evaluations.