Radioisotope synoviorthesis in pediatric and adolescent patients with hemophilia

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• 作者：A. Martí ; nez-Esteve^a ; ^{andres.martinez.esteve@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; R.M. Á ; lvarez-Pé ; rez^a ; R. Nú ; ñ ; ez-Vá ; zquez^b ; J.L. Tirado-Hospital^a ; R. Garcí ; a-Jimé ; nez^a ; J. Povedano-Gó ; mez^c ; I. Borrego-Dorado^a
• 关键词：Radioactive synoviorthesis ; Pediatric ; Adolescent ; Hemophilia ; 90Y ; 186Re
• 刊名：Revista Española de Medicina Nuclear e Imagen Molecular
• 出版年：2016
• 出版时间：January-February 2016
• 年：2016
• 卷：35
• 期：1
• 页码：12-16
• 全文大小：277 K

文摘

To assess the outcome and adverse-effects of the radioisotope synoviorthesis in pediatric and adolescent patients with hemophilia.

Material and methods

Prospective study of historical cohort was conducted. A total of 20 consecutive hemophiliacs with a mean age of 13.1 years (range 4–17) were included with a mean follow-up of 64.9 months (range 18–109). The diagnosis of synovitis was established on the basis of clinical follow-up including radiological images (radiography and/or MRI). For evaluation, the classification proposed by Fernandez-Palazzi was used. Inclusion criteria: Patients aged less than 18 years old with hemophilia and more than one haemarthrosis in less than 3 months remaining a chronic synovitis despite prophylactic therapy intensification. Exclusion criteria: Any contraindication for radionuclide synoviorthesis. Twenty-seven radioisotope synoviorthesis with ⁹⁰Y-citrate-colloid and/or ¹⁸⁶Re-sulphide-colloid were done. The effectiveness of the procedure was assessed through pre and posttreatment clinical comparison at 6 months after radioisotope synoviorthesis.

Results

Nineteen of the 27 synoviorthesis (70.3%) had a good or excellent response and 8 joints (29.7%) had partial response. It was necessary to repeat the procedure in 3 joints in 3 different patients, obtaining in all cases a good or excellent response. We appreciated inflammatory reaction after procedure in 4 cases (14.8%), which improved with analgesics and nonsteroidal anti-inflamatory drugs. None of the patients presented malignant or premalignant lesions during the follow-up.

Conclusion

The radionuclide synoviorthesis is a very effective procedure in pediatric and adolescent patients with hemophilia, being a minimally invasive procedure, easy to perform, safe and with minimal side effects.