Protein‐Losing Enteropathy Detected by 99mTc‐Labeled Human Serum Albumin Abdominal Scintigraphy

Abstract

Summary 99mTc‐labeled human serum albumin (HSA) abdominal imaging is a new way of demonstrating gastrointestinal protein loss. We present two children with hypoalbuminemia of obscure etiology in whom albumin loss was localized in the gastrointestinal tract with 99mTc‐HSA scintigraphy and the loss correlated with abnormal fecal α1‐antitrypsin excretion. In the absence of gastrointestinal blood loss or contamination of the 99mTc‐HSA with free pertechnetate, significant activity accumulating in the gastrointestinal tract and moving with its contents is thought to represent 99mTc‐HSA leakage into bowel lumen. Abdominal imaging with 99mTc‐HSA has a low radiation burden to the patient and is readily available, relatively inexpensive, and easily performed. It can be used as a screening test for the detection of protein‐losing enteropathy. It also offers the potential of being able to localize the site of protein loss visually within the gastrointestinal tract.