Nephrogenic systemic fibrosis: is gadolinium the missing piece to the puzzle?
New medical disorders arise infrequently, but nephrogenic systemic fibrosis (NSF) is one such entity. It exclusively affects patients with renal failure, resulting in debilitating progressive fibrosis of the skin and systemic organs. Although much work has been done elucidating the histopathologic changes, a trigger has not been detected. Recently, case reports have implicated gadolinium (Gd) contrast agents as a potential etiology, prompting a health advisory from the US Food and Drug Administration (FDA) in June 2006. We discuss the literature regarding the effects of Gd on tissue and its potential relationship to the known histopathologic characteristics of NSF.
Bennett
Lindsey K
LK
Department of Dermatology , University of Wisconsin, Madison, 1 South Park St, 7th Floor, Madison, WI 53715 USA. lk.bennett@hosp.wisc.edu
Garrett
Andrea L
AL
D000138:Acidosis / Q000150:complications; D003287:Contrast Media / Q000009:adverse effects*; D005355:Fibrosis / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D005682:Gadolinium / Q000009:adverse effects*; D019786:Gadolinium DTPA / Q000009:adverse effects*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy; D012307:Risk Factors; D012867:Skin / Q000473:pathology / Q000503:physiopathology; D012871:Skin Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology
D003287:Contrast Media; D005682:Gadolinium; D019786:Gadolinium DTPA