Document Detail


Absence of gadolinium deposits in the peritoneal membrane of patients with encapsulating peritoneal sclerosis.
MedLine Citation:
PMID:  20007759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Background. Encapsulating peritoneal sclerosis (EPS) is a severe complication of long-term peritoneal dialysis (PD) characterized by the development of an extensive fibrosis of the visceral peritoneum that may eventually lead to intestinal constriction. Its cause remains elusive. Nephrogenic systemic fibrosis (NSF), a disabling disease that can follow gadolinium-based contrast injection during magnetic resonance imaging, is characterized by systemic fibrosis of the skin, joints, liver, heart and vessels. Affected tissues are infiltrated by CD34+ and CD68+ fibroblasts. In the present study, we tested the hypothesis that EPS could have been triggered by a previous gadolinium injection. Methods. We performed histopathological analysis of the peritoneal membrane of two EPS and two control patients all exposed to long-term PD, including immunostaining with CD34 and CD68. The presence of gadolinium and other metals was also assessed by conventional and energy-filtered transmission electron microscopy. RESULTS: Numerous CD34+ and CD68+ cells were found in both the EPS and control patients within the vascular endothelium and in macrophages, respectively, but not in interstitial fibrocytes, as it could be expected in NSF. No trace of gadolinium deposits could be found in the four peritoneal samples; dispersed tiny iron inclusions were evidenced in the connective tissue of both EPS patients. CONCLUSIONS: These findings argue against the implication of gadolinium in the development of EPS in long-term PD patients.
Authors:
Eric Goffin; Josef A Schroeder; Christian Weingart; Pierre-Yves Decleire; Jean-Pierre Cosyns
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-12-10
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1334-9     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Université Catholique de Louvain, Cliniques Universitaires St Luc, Brussels, Belgium. eric.goffin@uclouvain.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Cell Membrane / pathology*
Contrast Media / adverse effects*
Female
Gadolinium DTPA / adverse effects*
Humans
Kidney Failure, Chronic / therapy
Magnetic Resonance Imaging
Male
Middle Aged
Nephrogenic Fibrosing Dermopathy / chemically induced*
Peritoneal Dialysis / adverse effects*
Peritoneal Fibrosis / complications*
Peritoneum / drug effects,  pathology*
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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