Michelet P-R, Chopard C Stoermann, Martin P-Y, Vallée J-P
Service de médecine interne générale, HUG, 1211 Genève 14.
Rev Med Suisse. 2008 Mar 5;4(147):576-8, 580.
Nephrogenic systemic fibrosis, another problem for patients with chronic renal failure Nephrogenic systemic fibrosis is a rare but severe disease described in patients with kidney failure. High morbidity ant mortality are associated with this new condition. Epidemiological studies strongly suggest a link between nephrogenic systemic fibrosis and gadolinium administration for magnetic resonance imaging enhancement. The disease is primarily cutaneous, with oedema affecting the limbs, later evolving to fibrosis that leads to joints contractures. The lesions can spread to the trunk and involve systemic organs like the heart, lungs and muscles. Given the lack of proved efficient therapy, careful evaluation of the risks and benefits of gadolinium administration should be done in patients with kidney disease. If really needed, a highly stable contrast media should be used.
肾源性系统性纤维化，慢性肾衰竭患者面临的另一个问题 肾源性系统性纤维化是一种在肾衰竭患者中出现的罕见但严重的疾病。这种新病症具有高发病率和高死亡率。流行病学研究有力地表明肾源性系统性纤维化与用于磁共振成像增强的钆剂给药之间存在联系。该疾病主要累及皮肤，水肿影响四肢，随后发展为纤维化，导致关节挛缩。病变可蔓延至躯干，并累及心脏、肺和肌肉等全身器官。鉴于缺乏经证实有效的治疗方法，对于肾病患者应仔细评估钆剂给药的风险和益处。如果确实需要，应使用高度稳定的造影剂。
