Peter Marckmann MD, Abstract Co-Author: Nothing to Disclose

Lone Skov, Abstract Co-Author: Nothing to Disclose

Kristian Rossen MD, Abstract Co-Author: Nothing to Disclose

Henrik S. Thomsen MD, Presenter: Nothing to Disclose

NSF is a rare, but serious disease occurring in patients with renal failure. It may be caused some of the Gd-containing contrast agents, in particularly the non-ionic linear less stable agent gadodiamide. The clinical picture and course of NSF is incompletely understood and described.

Retrospective, longitudinal cohort study based on medical records, personal interviews and physical examinations of 22 histologically verified cases of gadodiamide-related NSF.

In the large majority of patients, first signs of nephrogenic systemic fibrosis were skin discoloration/induration/warmth, itching, neuropathic symptoms, and constant pain localized to the lower legs and appearing within less than 2 months after gadodiamide-exposure. Associated early symptoms included sleeplessness and hair loss. The late clinical picture consisted primarily of skin stiffness with or without restricted joint movements. Ten of 22 patients (45%) were severely disabled from NSF an average of 30 months after being exposed to gadodiamide. Four patients died (18%, 95% CI: 6-41%). Almost half of the patients experienced some symptom improvement without having received any specific treatment and while still in renal failure.

The symptomatology of NSFchanges over time, and may take very different courses form patient to patient. If the disease is suspected it is essential to investigate the patient’s history of exposure to gadolinium-containing contrast agents, and to obtain skin biopsies from affected areas in order to confirm the diagnosis.

The signs/symptoms of NSF may vary over time.

Marckmann, P, Skov, L, Rossen, K, Thomsen, H, Gadodiamide-related Nephrogenic Systemic Fibrosis (NSF): Early Symptoms, Late Outcomes.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5004680.html