Gadolinium-induced nephrogenic systemic fibrosis in a patient with an acute and transient kidney injury.
Nephrogenic systemic fibrosis (NSF) describes a characteristic fibrosing disorder which typically presents with indurated plaques on the trunk and extremities of patients with advanced renal disease. We present a case of biopsy-confirmed NSF in a patient with severe acute kidney injury with no prior history of renal disease. A 64-year-old man with an acute and severe decrease in glomerular filtration rate underwent magnetic resonance imaging studies with gadolinium contrast (Omniscan) and subsequently developed NSF. His renal disease had normalized at the time his skin disease developed. Skin biopsies revealed findings of NSF and scanning electron microscopy with energy-dispersive X-ray spectroscopy confirmed insoluble gadolinium within lesional tissue.
Kalb
R E
RE
Department of Dermatology, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Williamsville, NY 14221, USA. kalb@buffalo.edu
Helm
T N
TN
Sperry
H
H
Thakral
C
C
Abraham
J L
JL
Kanal
E
E
D003287:Contrast Media / Q000009:adverse effects*; D005355:Fibrosis; D005682:Gadolinium / Q000009:adverse effects*; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000150:complications* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000528:radiation effects; D012871:Skin Diseases / Q000139:chemically induced*; D016896:Treatment Outcome
D003287:Contrast Media; D005682:Gadolinium