Nephrogenic Systemic Fibrosis Does Not Discriminate by Gender or Race
http://www.burgsimpson.com/nsf.htmlNephrogenic systemic fibrosis (NSF), a new fibrotic skin disease was first recognized in 1997 in 15 patients receiving hemodialysis for kidney failure. The early reports noted that it closely resembled scleromyxedema, but was different enough for further study. People with end-stage renal disease (ESRD), account for 90% of the patients. Peritoneal dialysis appears to be associated with a greater risk for NSF compared to hemodialysis. The age range is from 8 years to 87 years old and does not discriminate against gender or race. Many countries have reported cases of NSF. NSF has been linked to gadolinium exposure which is contained in contrast agents used in MRIs. The initial observation that vascular surgery and thrombotic episodes were common before symptoms occurred prompted speculation that NSF may be triggered by an imaging contrast agent. The time it takes for symptoms to appear is anywhere from 2 to 75 days of which 25 days is the median. As NSF progresses, patients may experience significant decrease in the function of their hands and feet, with the development of joint contracting and stiffening. Some ultimately are confined to a wheelchair and need assistance with daily activities. Severe disability and even death mortality have been reported in patients with NSF. In May of this year the manufacturers of gadolinium contrast agents issued a “Dear Healthcare Professional” letter to inform them of the newly added “Black Box” warning added in the prescribing information for patients with renal failure.
