Marckmann Peter, Skov Lone, Rossen Kristian, Dupont Anders, Damholt Mette Brimnes, Heaf James Goya, Thomsen Henrik S
Department of Nephrology, Copenhagen University Hospital at Herlev, DK-2730 Herlev, Denmark.
J Am Soc Nephrol. 2006 Sep;17(9):2359-62. doi: 10.1681/ASN.2006060601. Epub 2006 Aug 2.
Nephrogenic systemic fibrosis is a new, rare disease of unknown cause that affects patients with renal failure. Single cases led to the suspicion of a causative role of gadodiamide that is used for magnetic resonance imaging. This study therefore reviewed all of the authors' confirmed cases of nephrogenic systemic fibrosis (n = 13) with respect to clinical characteristics, gadodiamide exposure, and subsequent clinical course. It was found that all had been exposed to gadodiamide before the development of nephrogenic systemic fibrosis. The delay from exposure to first sign of the disease was 2 to 75 d (median 25 d). Odds ratio for acquiring the disease when gadodiamide exposed was 32.5 (95% confidence interval 1.9 to 549.2; P < 0.0001). Seven (54%) patients became severely disabled, and one died 21 mo after exposure. No other exposure/event than gadodiamide that was common to more than a minority of the patients could be identified. These findings indicate that gadodiamide plays a causative role in nephrogenic systemic fibrosis.
肾源性系统性纤维化是一种病因不明的新型罕见疾病，影响肾衰竭患者。个别病例引发了对用于磁共振成像的钆双胺致病作用的怀疑。因此，本研究回顾了所有作者确诊的肾源性系统性纤维化病例（n = 13），涉及临床特征、钆双胺暴露情况及后续临床病程。结果发现，所有患者在肾源性系统性纤维化发病前均接触过钆双胺。从接触到疾病首发症状的延迟时间为2至75天（中位数25天）。接触钆双胺后患病的优势比为32.5（95%置信区间1.9至549.2；P < 0.0001）。7名（54%）患者出现严重残疾，1名患者在接触后21个月死亡。未发现除钆双胺外，大多数患者共有的其他暴露/事件。这些发现表明钆双胺在肾源性系统性纤维化中起致病作用。
