Sympathetic Overactivity in Uremia Detected by 1231-MIBG Scintigraphy

Iodine-123 metaiodobenzylguanidine (I-123 MIBG) scintigraphy is a common method used to image pheochromocytomas, which are known to be responsible for 0.1% of cases of hypertension. A 31-year-old woman with terminal uremia was referred to our department because of paroxysmal hypertension and slightly elevated (nor)metanephrines, leading to the suspicion of pheochromocytoma. Accordingly, an I-123 MIBG scintigraphy was performed. MIBG is taken up and stored by the same mechanism as norepinephrine. However, as terminal uremia is known to lead to cardiac sympathetic overactivity and disturbances in the autonomic nervous system, this could possibly influence tracer distribution.