NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Early Recognition and Treatment

Knopp, Eleanor A.; Cowper, Shawn E.

doi:10.1111/j.1525-139x.2007.00399.x

Cited by 60 publications

(54 citation statements)

References 54 publications

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“…7, A and B). The histology of NSF-afflicted skin was also remarkable for increased cellularity, with factor XIIIa ϩ dendritic cells (9,19). In experimental animals, factor XIIIa was increased in the dermis 3 H]thymidine incorporation in quiescent human foreskin fibroblasts (HFFs).…”

Section: In Vivo Experimentsmentioning

confidence: 97%

Type of MRI contrast, tissue gadolinium, and fibrosis

Barnes

Tan

et al. 2014

American Journal of Physiology-Renal Physiology

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It has been presupposed that the thermodynamic stability constant ( Ktherm) of gadolinium-based MRI chelates relate to the risk of precipitating nephrogenic systemic fibrosis. The present study compared low- Ktherm gadodiamide with high- Ktherm gadoteridol in cultured fibroblasts and rats with uninephrectomies. Gadolinium content was assessed using scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy in paraffin-embedded tissues. In vitro, fibroblasts demonstrated dose-dependent fibronectin generation, transforming growth factor-β production, and expression of activated myofibroblast stress fiber protein α-smooth muscle actin. There were negligible differences with respect to toxicity or proliferation between the two contrast agents. In the rodent model, gadodiamide treatment led to greater skin fibrosis and dermal cellularity than gadoteridol. In the kidney, both contrast agents led to proximal tubule vacuolization and increased fibronectin accumulation. Despite large detectable gadolinium signals in the spleen, skin, muscle, and liver from the gadodiamide-treated group, contrast-induced fibrosis appeared to be limited to the skin and kidney. These findings support the hypothesis that low- Ktherm chelates have a greater propensity to elicit nephrogenic systemic fibrosis and demonstrate that certain tissues are resistant to these effects.

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Section: In Vivo Experimentsmentioning

confidence: 97%

Type of MRI contrast, tissue gadolinium, and fibrosis

Barnes

Tan

et al. 2014

American Journal of Physiology-Renal Physiology

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“…Skin biopsies demonstrate dermal fibrosis with a significant increase in cellularity, but no inflammation (59). Often the cells are described as being spindle shaped (61,77), fibroblasts (6), fibroblast like (56), fibrohistiocytic (68,75,82), or "polygonal epitheliod fibroblasts" (6).…”

Section: Histology and Immunohistologymentioning

confidence: 99%

Pathophysiology of gadolinium-associated systemic fibrosis

Wagner

Drel

Gorin

2016

American Journal of Physiology-Renal Physiology

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“…NSF has no single diagnostic, clinical or histologic feature. The clinical picture in NSF is very similar to scleromyxedema, but NSF favors the extremities and trunk rather than the head and neck [10]. Other differentials such as morphea differ both clinically and histologically) [11].…”

Section: Nsf As a Distinct Clinicopathological Entitymentioning

confidence: 96%

Gadolinium and nephrogenic systemic fibrosis: an update

2013

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Nephrogenic systemic fibrosis (NSF) is a multisystem disease seen exclusively in patients with renal impairment. It can be severely debilitating and sometimes fatal. There is a strong association with gadolinium-based contrast agents used in magnetic resonance imaging (MRI). Risk factors include renal impairment and proinflammatory conditions, e.g. major surgery and vascular events. Although there is no single effective treatment for NSF, the most successful outcomes are seen following restoration of renal function, either following recovery from acute kidney injury or following renal transplantation. There have been ten biopsy-proved pediatric cases of NSF, with no convincing evidence that children have a significantly altered risk compared with the adult population. After implementation of guidelines restricting the use of gadolinium-based contrast agents in at-risk patients, there has been a sharp reduction in new cases and no new reports in children. Continued vigilance is recommended: screening for renal impairment, use of more stable gadolinium chelates, consideration of non-contrast-enhanced MRI or alternative imaging modalities where appropriate.

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NSF: WHAT WE KNOW AND WHAT WE NEED TO KNOW: Nephrogenic Systemic Fibrosis: Early Recognition and Treatment

Cited by 60 publications

References 54 publications

Type of MRI contrast, tissue gadolinium, and fibrosis

Type of MRI contrast, tissue gadolinium, and fibrosis

Pathophysiology of gadolinium-associated systemic fibrosis

Gadolinium and nephrogenic systemic fibrosis: an update

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