Serial scintigraphic assessment of iodine-123 metaiodobenzylguanidine lung uptake in a patient with high-altitude pulmonary edema

Iodine-123 metaiodobenzylguanidine (I-123-MIBG) can be considered an indicator of pulmonary endothelial cell function. Serial I-123-MIBG images of the chest were acquired in a patient with high altitude pulmonary edema (HAPE). The initial evaluation was performed 7 days after admission. The lung to upper mediastinum ratios (LMRs) of I-123-MIBG up-take were 1.33 (for the right lung) and 1.12 (for,the left lung). The second examination of I-123-MIBG lung uptake; which was performed 2 months later, showed LMRs of 1.39 (right lung) and 1.33 (left lung). We speculated that the decreased lung uptake of I-123-MIBG at the early recovery stage could reflect an impairment in pulmonary endothelial cell metabolic function in the development of HAPE.