Department of Medicine (Dermatology), Vanderbilt University, Nashville, Tennessee, USA.
J Am Acad Dermatol. 2010 Feb;62(2):337-42. doi: 10.1016/j.jaad.2009.04.010. Epub 2009 Nov 24.
Nephrogenic systemic fibrosis is a condition with significant and often debilitating cutaneous manifestations. Recent research on this disease has delineated an association between nephrogenic systemic fibrosis and exposure to magnetic resonance imaging studies using gadolinium-based contrast agents in patients with ongoing renal failure. This metal has been detected in cutaneous biopsy specimens taken from lesional skin suggesting that gadolinium provides an impetus for the deposition of circulating fibrocytes in the skin and subsequent fibrosis. We describe a hemodialysis-dependent liver transplant recipient who received a gadolinium-based contrast agent and demonstrated insoluble gadolinium deposition in a fibrotic dermis and subcutaneous septum using scanning electron microscopy/energy dispersive x-ray spectroscopy. He has yet to manifest symptoms and signs of nephrogenic systemic fibrosis 3 years after his magnetic resonance imaging study.
肾源性系统性纤维化是一种具有显著且常导致身体虚弱的皮肤表现的病症。最近对该病的研究表明，肾源性系统性纤维化与接受使用含钆造影剂的磁共振成像研究的慢性肾衰竭患者之间存在关联。该金属已在取自病变皮肤的皮肤活检标本中检测到，提示钆为循环成纤维细胞在皮肤中的沉积以及随后的纤维化提供了动力。我们描述了一位依赖血液透析的肝移植受者，他接受了含钆造影剂，并通过扫描电子显微镜/能量色散 X 射线光谱在纤维化真皮和皮下隔室内显示出不溶性钆沉积。在他进行磁共振成像研究 3 年后，他尚未出现肾源性系统性纤维化的症状和体征。
