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Serial Scintigraphic Assessment of Iodine-123 Metaiodobenzylguanidine Lung Uptake in a Patient With High-Altitude Pulmonary Edema*

Tomonobu Koizumi, MD; Keishi Kubo, MD; Masayuki Hanaoka, MD; Hiroshi Yamamoto, MD; Shinji Yamaguchi, MD; Tadashige Fujii, MD; Toshio Kobayashi, MD
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*From the First Department of Internal Medicine, Shinshu University School of Medicine, Asahi Matsumoto, Japan.

Correspondence to: Keishi Kubo, MD, First Department of Internal Medicine, Shinshu University School of Medicine, 3–1-1 Asahi Matsumoto, 390-8621, Japan; e-mail: keishik@gipac.shinshu-u.ac.jp



Chest. 1999;116(4):1129-1131. doi:10.1378/chest.116.4.1129
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Iodine-123 metaiodobenzylguanidine (123I-MIBG) can be considered an indicator of pulmonary endothelial cell function. Serial 123I-MIBG images of the chest were acquired in a patient with high altitude pulmonary edema (HAPE). The initial evaluation was performed 7 days after admission. The lung to upper mediastinum ratios (LMRs) of 123I-MIBG uptake were 1.33 (for the right lung) and 1.12 (for the left lung). The second examination of 123I-MIBG lung uptake, which was performed 2 months later, showed LMRs of 1.39 (right lung) and 1.33 (left lung). We speculated that the decreased lung uptake of 123I-MIBG at the early recovery stage could reflect an impairment in pulmonary endothelial cell metabolic function in the development of HAPE.

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