Nephrogenic systemic fibrosis (NSF) is a progressive systemic fibrosing disease that may occur after gadolinium contrast exposure. It can lead to severe complications and even death. NSF is highly prevalent among patients with advanced chronic kidney disease (CKD). In this report, however, we describe the case of a patient with NSF that occurred during early CKD. A 65-year-old man with stage 3a CKD was transferred to our hospital because of lower extremity edema. The medical history revealed that he was exposed to gadolinium 185 days earlier, and the result of his tibial skin biopsy was consistent with NSF. The patient underwent a combined therapy with ultraviolet-A1 phototherapy and methotrexate and steroid therapy for 6 months. The combined therapy stopped the systemic progression of NSF.
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| http://dx.doi.org/10.3346/jkms.2020.35.e293 | DOI Listing |
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- Since 2006, neuroradiologists have restricted the use of gadolinium-based contrast agents (GBCAs) in patients with chronic kidney disease (CKD) to prevent nephrogenic systemic fibrosis (NSF), significantly reducing its occurrence.
- In 2023-2024, the American Society of Neuroradiology reviewed recent research on GBCA safety to update guidelines for MRI contrast use in CKD patients.
- The ASNR now recommends that Group II GBCAs can be safely used in CKD patients when necessary for diagnosis, and additional safety measures like checking renal function may be relaxed.
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