Document Detail


Nephrogenic systemic fibrosis: a report of 29 cases.
MedLine Citation:
PMID:  18287446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to determine the incidence of nephrogenic systemic fibrosis and its relation to renal failure and the administration of gadolinium-based contrast material at an academic medical center. MATERIALS AND METHODS: A dermatopathology database was searched to identify patients in whom nephrogenic systemic fibrosis was diagnosed. The medical records of these patients were reviewed. Renal function concurrent with any administration of gadolinium-based contrast material was assessed, as was patient outcome. A database of patients undergoing long-term dialysis was reviewed separately to determine how many had received gadolinium and the frequency of nephrogenic systemic fibrosis among these patients. RESULTS: Twenty-nine patients were found to have had nephrogenic systemic fibrosis between November 15, 1999, and December 31, 2006. It was known that gadolinium-based contrast material had been administered to 25 of these patients before diagnosis. All 29 patients had compromised renal function (27 had chronic renal failure, and two had acute renal failure). Determination of the temporal relation between gadolinium-based contrast administration and symptom onset often was difficult. Only eight patients had severe morbidity. Nephrogenic systemic fibrosis developed in 12 (2.9%) of 414 patients undergoing long-term dialysis who received gadolinium-based contrast material. CONCLUSION: We confirm the strong association between nephrogenic systemic fibrosis and gadolinium-based contrast administration. Although the use of high doses of gadolinium and the occurrence of chronic renal failure have been implicated in other reports, several of our patients received standard doses of gadolinium, and two had transient acute renal failure before diagnosis. Most patients had mild or moderate symptoms. Nephrogenic systemic fibrosis developed in 2.9% of patients undergoing long-term dialysis who received gadolinium-based contrast material but in none of the long-term dialysis patients who did not receive gadolinium-based contrast material.
Authors:
Wael M Shabana; Richard H Cohan; James H Ellis; Hero K Hussain; Isaac R Francis; Lyndon D Su; Suresh K Mukherji; Richard D Swartz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  190     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-21     Completed Date:  2008-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  736-41     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, University of Michigan Hospitals, 1500 E Medical Center Dr., Room-B1D502G, Ann Arbor, MI 48109-0030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cohort Studies
Contrast Media / administration & dosage,  adverse effects*
Databases, Factual
Fibrosis
Gadolinium / administration & dosage,  adverse effects*
Humans
Kidney Failure / complications*,  therapy
Magnetic Resonance Imaging*
Middle Aged
Prevalence
Renal Dialysis*
Retrospective Studies
Skin Diseases / epidemiology*
Chemical
Reg. No./Substance:
0/Contrast Media; 7440-54-2/Gadolinium

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


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