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Nephrogenic systemic fibrosis associated with gadolinium use.
Chi-Chao Chao1, Chih-Chao Yang, Cheng-Hsiang Hsiao
1Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|April 11, 2008
Summary
Nephrogenic systemic fibrosis (NSF) is a serious condition linked to gadolinium-contrast (Gd-contrast) in patients with kidney disease. This report highlights two cases, suggesting caution with Gd-contrast in end-stage renal disease patients, especially with surgery.
Area of Science:
- Nephrology
- Radiology
- Pathology
Background:
- Nephrogenic systemic fibrosis (NSF) is a debilitating fibrotic condition primarily affecting patients with severe renal impairment.
- Gadolinium-containing contrast agents (Gd-contrast) have been increasingly implicated as a potential etiological factor in NSF development.
Observation:
- Two female patients with end-stage renal disease (ESRD) developed histologically confirmed NSF following exposure to Gd-contrast.
- Clinical manifestations included progressive skin and muscle fibrosis, induration, and joint contractures, predominantly in the limbs.
Findings:
- NSF onset occurred after Gd-contrast enhanced magnetic resonance imaging (MRI) in both patients.
- Surgical procedures preceded or coincided with NSF development, suggesting a potential synergistic role.
Implications:
- The findings underscore the need for cautious use of Gd-contrast agents in patients with ESRD.
- Further research is warranted to elucidate the precise mechanisms linking Gd-contrast, surgical stress, and NSF pathogenesis.
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