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Utility of 18 F‐FDG PET/CT scan to diagnose the etiology of fever of unknown origin in patients on dialysis
Author(s) -
Tek Chand Kalawat,
Chennu Krishna Kishore,
Amancharla Yadagiri Lakshmi,
Manthri Gupta Ranadheer,
Rapur Ram,
Vishnubotla Siva Kumar
Publication year - 2017
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/hdi.12471
Subject(s) - medicine , fever of unknown origin , hemodialysis , dialysis , radiology , end stage renal disease , kidney disease , stage (stratigraphy) , paleontology , biology
Studies on fever of unknown origin (FUO) in patients of chronic kidney disease and end stage renal disease patients on dialysis were not many. In this study, we used 18 F‐FDG PET/CT scan whole body survey for detection of hidden infection, in patients on dialysis, labelled as FUO. Methods: In this retrospective study, 20 patients of end stage renal disease on dialysis were investigated for the cause of FUO using 18F‐FDG PET/CT scan. All these patients satisfied the definition of FUO as defined by Petersdorf and Beeson. Any focal abnormal site of increased FDG concentration detected by PET/CT, either a solitary or multiple lesions was documented and at least one of the detected abnormal sites of radio tracer concentration was further examined for histopathology. Findings: All patients were on renal replacement therapy. Of these, 18 were on hemodialysis and two were on peritoneal dialysis. 18F‐FDG PET/CT scan showed metabolically active lesions in 15 patients and metabolically quiescent in five patients. After 18F‐FDG PET/CT scan all, but one patient had a change in treatment for fever. Anti‐tuberculous treatment was given in 15 patients, antibiotics in four patients and anti‐malaria treatment in one patient. Discussion: The present study is first study of 18F‐FDG PET/CT scan in patients of end stage renal disease on dialysis with FUO. The study showed that the 18 F FDG PET/CT scan may present an opportunity to attain the diagnosis in end stage renal disease patients on dialysis with FUO.