Khurana Anand, Greene John F, High Whitney A
Department of Nephrology, Scott & White Clinic, Texas A & M University, College Station, Texas, USA.
J Am Acad Dermatol. 2008 Aug;59(2):218-24. doi: 10.1016/j.jaad.2008.04.010. Epub 2008 Jun 5.
Nephrogenic systemic fibrosis (NSF) has been associated with exposure to gadolinium-based contrast agent (GdCA) used in medical imaging.
We sought to quantify levels of gadolinium in affected skin of patients with NSF and correlate the levels to clinical and laboratory parameters.
Skin biopsy specimens were analyzed using inductively coupled plasma mass spectroscopy (ICP-MS) and the micrograms of gadolinium per gram (microg/g) of dry tissue were determined. Clinical and laboratory data were obtained through retrospective chart review. Pearson correlation coefficients were used to correlate tissue gadolinium levels with various parameters.
Six patients from a prior cohort were analyzed for gadolinium in affected skin. The mean amount of gadolinium in affected skin of NSF patients was 320.1 microg/g. No gadolinium was found in limited control tissue from patients unexposed to GdCA or in patients exposed to such agents, but without disease. Higher levels of gadolinium in skin correlated with younger age, lower body weight, lower corrected serum calcium levels, and lower erythropoietin dosing.
The study was limited by the small number of cases and by the retrospective nature of the data and skin samples.
Gadolinium is present in substantial amounts within the skin of patients with NSF. Quantification of gadolinium in tissue using ICP-MS may facilitate our understanding of the disease.
肾源性系统性纤维化（NSF）与医学成像中使用的钆基造影剂（GdCA）暴露有关。
我们试图量化NSF患者受累皮肤中的钆水平，并将这些水平与临床和实验室参数相关联。
使用电感耦合等离子体质谱法（ICP-MS）分析皮肤活检标本，测定每克干组织中钆的微克数（μg/g）。通过回顾性病历审查获得临床和实验室数据。使用Pearson相关系数将组织钆水平与各种参数相关联。
对先前队列中的6名患者的受累皮肤进行了钆分析。NSF患者受累皮肤中钆的平均含量为320.1μg/g。在未接触GdCA的患者或接触此类药物但无疾病的患者的有限对照组织中未发现钆。皮肤中较高的钆水平与较年轻的年龄、较低的体重、较低的校正血清钙水平和较低的促红细胞生成素剂量相关。
该研究受病例数量少以及数据和皮肤样本的回顾性性质限制。
钆大量存在于NSF患者的皮肤中。使用ICP-MS对组织中的钆进行定量分析可能有助于我们对该疾病的理解。
