Document Detail


Extracorporeal photopheresis improves nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis: three case reports and review of literature.
MedLine Citation:
PMID:  18633995     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis (NFD/NSF) is a recently recognized systemic fibrosing disorder that develops in the context of renal insufficiency. Its predominant manifestation is severe cutaneous fibrosis, often causing disabling contractures of neighboring joints. No therapy is consistently effective, and etiology and pathogenesis remain obscure. However, gadolinium-containing contrast agents used in magnetic resonance imaging or angiography have recently been strongly linked to the development of fibrosis in NSF. We report a clinical response to treatment with extracorporeal photopheresis (ECP) using the Therakos UVAR XTS system in three cases of NFD/NSF associated with flexion contractures affecting all four limbs. All three patients were receiving renal replacement therapy for longstanding end-stage renal failure. All three showed clinical response with softening of skin plaques at the end of four cycles, and improved range of movement in all four limbs on completion of treatment. The first patient, with NFD/NSF of 4.5 year's duration, was able to resume most activities of daily living although still chairbound, while a second patient with more recent onset of NSF was able to walk short distances with the help of Zimmer frames by the end of 16-18 cycles of treatment, having been chairbound pretreatment. A third patient with milder initial symptoms also experienced significant improvement after a shorter course of ECP treatment. Our experience with these three patients confirms previous case reports, suggesting that ECP may be effective in NFD/NSF.
Authors:
Kiran Mathur; Scott Morris; Chris Deighan; Rachel Green; Kenneth William Douglas
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of clinical apheresis     Volume:  23     ISSN:  1098-1101     ISO Abbreviation:  J Clin Apher     Publication Date:  2008  
Date Detail:
Created Date:  2008-08-11     Completed Date:  2008-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8216305     Medline TA:  J Clin Apher     Country:  United States    
Other Details:
Languages:  eng     Pagination:  144-50     Citation Subset:  IM    
Affiliation:
Clinical Apheresis Unit, The Beatson, West of Scotland Cancer Center, Glasgow, Scotland, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Fibrosis
Humans
Joint Diseases / pathology,  therapy*
Kidney Failure, Chronic / pathology,  therapy*
Male
Middle Aged
Photopheresis* / instrumentation,  methods
Skin Diseases / pathology,  therapy*
Time Factors

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


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