[Markedly decreased cardiac uptake with 123I-MIBG scintigraphy in a case of pure progressive autonomic failure]

Abstract

A 70-year-old man with about 25 years' history of autonomic nervous system disturbances including orthostatic hypotension is presented. He had had no extrapyramidal and cerebellar signs, and was diagnosed as having pure progressive autonomic failure. His cardiac imaging with 123I labeled MIBG (metaiodobenzylguanidine) showed extremely diminished uptake, but the imaging with 201-thallium showed a normal cardiac uptake. Those results indicate non-cardiac disease-associated (neurogenic) postganglionic sympathetic fiber abnormality innervating the heart. Also, adrenomedullary imaging with 123I labeled MIBG showed no adrenal image, which suggests the possibility that there should be dysfunction in the adrenal medulla of this patient. This imaging study is thought to be useful for evaluating autonomic nervous system function in neurologic diseases.