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Erythrocyte Magnesium Concentration in Systemic Sarcoidosis, Indicating Granulomatous Myocardial Involvement FREE TO VIEW

Ioannis Angomachalelis, PhD; Hercules Titopoulos, PhD; George Kyriazis, PhD; Nestor Angomachalelis, PhD
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Aristotle University of Thessaloniki School of Medicine, Department of Medicine, Clinical Pulmonology, Heart-Lung Section, "G.Papanickolaou" General Hospital, Thessaloniki, Greece

Chest. 2013;144(4_MeetingAbstracts):460A. doi:10.1378/chest.1704233
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SESSION TITLE: Biomarkers in ILD

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 29, 2013 at 04:30 PM - 05:30 PM

PURPOSE: The Study aims to investigate determination of erythrocyte (RC) and plasma (PL) Magnesium levels in biopsy-proven Sarcoidosis patients(Pts) with no history of special diet or drug therapy,hypercalcemia,nephrolithiasis and any cardiovascular pathology.

METHODS: Clinical Examination,ECG,Atomic Absorption Spectrophotometry and Technetium-99m-Pyrophosphate(Tc-99m-Pyp) Myocardial Scintigraphy were applied in studying 31 Pts,8 males and 23 females (mean age 45,5±10 years) and 86 normal subjects (mean age 46±12 years).Isotope uptake was recorded two hours after intravenous injection of 20 mCi and evaluated by percent bias between precardial and right parasternal area, unavoidably, quite independent from and not influenced by dose infusion,body weight or surface area and renal dysfunction.

RESULTS: The results showed 1.Decreased RC Magnesium concentration in 48% of Pts but normal PL levels in all of them (RC 4.15±0.93 and PL 1.62±0.15 mEq/L 2.Normal Erythrocyte and Plasma Magnesium values in Nls (RC 4.5±0.37 ,PL 1.65±0.11 mEq/L). 3. Abnormal RC Magnesium values in 42.3% of Pts. 4. Tc-99m-Pyp myocardial scintigraphy was found abnormal in 49% of Pts.

CONCLUSIONS: 1.Statistical significant difference was confirmed between RC Magnesium values of Sarcoidosis Pts and Normals (t=2.92 , 0.01>p>0.0010 ). 2. Abnormal Tc-99m-Pyp myocardial imaging could be suggestive of sarcoid myocardial involvement 3 Decreased RC Magnesium levels of unknown origin, coincident with abnormal myocardial scintigraphy could be strongly compatible with sarcoid myocardial infiltration. 4.We stress the extraordinary diagnostic value of the isotope uptake percent bias methodology,not well established so far and reported in the literature, in the use of Tc-99m-Pyp radionuclide myocardial scintigraphy.

CLINICAL IMPLICATIONS: Further investigation and combination studies should be carried out to approve diagnostic reliability of the reported data,indicating, noninvasively, presence of myocardial sarcoid granulomatosis and possibly replacing performance of a diagnostic endomyocardial biopsy.

DISCLOSURE: The following authors have nothing to disclose: Ioannis Angomachalelis, Hercules Titopoulos, George Kyriazis, Nestor Angomachalelis

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