18F-Flurodeoxyglucose and 18F-Sodium Fluoride Positron Emission Tomography/Computed Tomography Imaging of Arterial and Cutaneous Alterations in Pseudoxanthoma Elasticum
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- fluorodeoxyglucose F18
- positron emission tomography computed tomography
- pseudoxanthoma elasticum
- sodium fluoride
- vascular calcification
Pseudoxanthoma elasticum (PXE) is an autosomal recessive metabolic disorder characterized by fragmentation and progressive calcification of elastic fibers in connective tissues, such as the skin, vascular system, and Bruch’s membrane.1 PXE is caused by mutations in the ABCC6 gene, on the short arm of chromosome 16, encoding a transmembrane ATP-binding anion transporter primarily expressed in the liver/kidney.1 Its pathophysiology is unknown, but in several studies, normal tissues exposed to patient with PXE serum/plasma tend to calcify.1 PXE manifestations include yellowish papules on the neck and in large skin folds and cardiovascular complications, such as peripheral artery disease resulting from tunica media calcifications in medium/small-sized arteries.1 Vascular histological studies are limited by poor availability of artery tissue in patients with advanced disease and are unsuitable for longitudinal study of disease progression. Alternative techniques are, therefore, required to investigate the pathogenesis and progression of this condition. In a previous case series, skin and vascular calcification was investigated using 18F-sodium fluoride (18F-NaF) positron emission tomography combined with computed tomographic imaging in 4 patients with PXE.2 18F-flurodeoxyglucose (18F-FDG) has been used in several studies to investigate vascular conditions wherein inflammation is considered essential in the pathogenesis of conditions, such as atherosclerotic plaque.3 Our report hypothesized that in patients with PXE, low-grade chronic inflammation may precede or evolve concomitantly with skin and vascular wall calcification. We report the case of a 42-year-old smoker, …