MRI Can Lead to Incurable Disease Part VI

Tuesday, 4th November 2008

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

NFD/NSF: What’s the Prognosis (likely outcome)?

As NSF is a rare, relatively recent diagnosis, the natural history of the disease is not well understood. Some patients report a gradual improvement in mobility and slight softening of the skin over time. Complete spontaneous healing in a patient with ongoing kidney disease has not yet been reported.

Several patients with NSF have died as a result of complications of their kidney disease or transplant surgery. One patient, who elected to discontinue dialysis, had widespread fibrosis involving the diaphragm, psoas muscles, proximal esophagus and intimal areas of vessels of the kidney and lungs.

As mentioned above, some patients with NSF (estimated at 5% or less) have an exceedingly rapid and fulminant disease course that may result in death. NSF, by itself, is not a cause of death, but may contribute to death by restricting effective ventilation, or by restricting mobility to the point of causing an accidental fall that may be further exacerbated by fractures and clotting complications.

The primary source of the technical information contained in this article is The International Center for Nephrogenic Fibrosing Dermopathy Research (ICNFDR)http://www.pathmax.com/dermweb/ .  This site was created by by Shawn E. Cowper, MD Assistant Professor of Dermatology and Pathology  Yale University

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