Gadolinium is not the only trigger for nephrogenic systemic fibrosis

Insights from two cases and review of the recent literature

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Nephrogenic systemic fibrosis (NSF) is an emerging fibrosing disease with serious consequences in patients with acute and chronic kidney disease including solid organ and renal transplant recipients. It has recently been linked to gadolinium exposure. Almost all recently reported cases of NSF were found to be preceded by gadolinium administration, which led the FDA to issue a warning against the use of gadolinium in patients with moderate-to-severe reduction in the glomerular filtration rate. We report two organ transplant recipients who developed NSF and in whom extensive record review failed to document any prior gadolinium exposure. We then critically review the recently published literature linking NSF and gadolinium and we propose other possible triggers. We conclude that gadolinium is not the only trigger for NSF, and that the search for other triggers should be sought. We believe that this information is an important addition to the NSF literature, such that the definitive etiology and pathogenesis of NSF can be researched.

Original languageEnglish (US)
Pages (from-to)2425-2432
Number of pages8
JournalAmerican Journal of Transplantation
Volume7
Issue number10
DOIs
StatePublished - Oct 2007

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Nephrogenic Fibrosing Dermopathy
Gadolinium
Transplants
Glomerular Filtration Rate
Chronic Renal Insufficiency
Kidney

Keywords

  • Gadolinium
  • Immunosuppression
  • Nephrogenic fibrosing dermopathy
  • Nephrogenic systemic fibrosis
  • Solid organ transplant

ASJC Scopus subject areas

  • Immunology

Cite this

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title = "Gadolinium is not the only trigger for nephrogenic systemic fibrosis: Insights from two cases and review of the recent literature",
abstract = "Nephrogenic systemic fibrosis (NSF) is an emerging fibrosing disease with serious consequences in patients with acute and chronic kidney disease including solid organ and renal transplant recipients. It has recently been linked to gadolinium exposure. Almost all recently reported cases of NSF were found to be preceded by gadolinium administration, which led the FDA to issue a warning against the use of gadolinium in patients with moderate-to-severe reduction in the glomerular filtration rate. We report two organ transplant recipients who developed NSF and in whom extensive record review failed to document any prior gadolinium exposure. We then critically review the recently published literature linking NSF and gadolinium and we propose other possible triggers. We conclude that gadolinium is not the only trigger for NSF, and that the search for other triggers should be sought. We believe that this information is an important addition to the NSF literature, such that the definitive etiology and pathogenesis of NSF can be researched.",
keywords = "Gadolinium, Immunosuppression, Nephrogenic fibrosing dermopathy, Nephrogenic systemic fibrosis, Solid organ transplant",
author = "Wahba, {I. M.} and Eric Simpson and Kevin White",
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