NEPHROGENIC SYSTEMIC FIBROSIS: A HIGHLY RELEVANT AND SIGNIFICANT ADVERSE EFFECT ASSOCIATED WITH GADOLINIUM BASED MRI CONTRAST AGENTS
Dr. Poonam Vohra* and Dr. Varun P. Kasana
ABSTRACT
Nephrogenic systemic fibrosis (NSF), also known as nephrogenic fibrosing dermopathy (NFD), is a disease of fibrosis of the skin and internal organs reminiscent but distinct from scleroderma or scleromyxedema. It is caused by gadolinium exposure used in imaging in patients who have renal insufficiency. Nephrogenic systemic fibrosis always occurs in patients with renal insufficiency who have had imaging studies (eg, magnetic resonance angiography) with gadolinium, a contrast agent used in imaging studies. Nephrogenic systemic fibrosis resembles scleroderma and eosinophilic fasciitis clinically and scleromyxedema histopathologically. Patients with nephrogenic systemic fibrosis may develop large areas of indurated skin with fibrotic nodules and plaques. Flexion contractures with an accompanying limitation of range of motion also can occur.
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