Bilateral Striatal Hypometabolism on FDG PET in a Patient With McLeod Syndrome.

Xu, Dan; Wang, Yichun; Li, Qijun; Wang, Lin · Clin Nucl Med · 2026

case_report · Level V

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Abstract

18 F-FDG PET scan performed on a 59-year-old man with progressive chorea, cognitive decline, peripheral neuropathy, and elevated creatine kinase revealed marked bilateral caudate and putamen hypometabolism. Huntington disease was suspected but HTT testing was negative. Whole-exome sequencing identified a hemizygous XK mutation (c.664C>T, p.(Arg222*)), confirming McLeod syndrome. This case highlights that bilateral striatal hypometabolism with peripheral involvement in addition to extrapyramidal symptoms should raise suspicion for McLeod syndrome.

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