MRI Can Lead to Incurable Disease Part III

Tuesday, 4th November 2008

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Gadolinium injection used to get a better MRI image can cause a rare disease known as nephrogenic fibrosing dermopathy (NFD) or  nephrogenic systemic fibrosis (NSF) in people with kidney problems.

NFD/NSF: What Are The Symptoms?

Patients with NSF describe swelling and tightening of the skin, usually limited to the arms and legs but sometimes involving the trunk of the body.  The condition may develop over a period of days to several weeks. In many cases, the skin thickening inhibits the movement of the joints, resulting in a condition where the joint is bent and will not move.   Severely affected patients may be unable to walk, or fully extend the joints of their arms, hands, legs, and feet. Complaints of muscle weakness are common. Approximately 5% of patients have a rapidly progressive course.

The skin changes may start as reddened or darkened patches or bumps.  In time, the skin may feel “woody” and the surface may resemble the texture of the peel of an orange. Patients may experience burning, itching, or severe sharp pains in areas of involvement.   Deep “bone pain” has been described in the hips and in the ribs.

The skin injuries are commonly symmetrical, with zones between the ankles and thighs most commonly involved, followed by involvement between the wrist and upper arms. Hand and foot swelling with blister-like damage has also been reported. Some patients have reported yellow bumps or patches on or near the eyes. Rapid, new onset fluctuating high blood pressure of unknown cause has been described prior to the onset of the skin damage.

From The International Center for Nephrogenic Fibrosing Dermopathy Research (ICNFDR)http://www.pathmax.com/dermweb/ .  The site was created by by Shawn E. Cowper, MD Assistant Professor of Dermatology and Pathology  Yale University

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