Objective. Evaluate the incidence of nephrogenic systemic fibrosis (NSF) in patients with liver disease in the peritransplant period. Materials and Methods. This IRB approved study retrospectively reviewed patients requiring transplantation for cirrhosis, hepatocellular carcinoma (HCC), or both from 2003 to 2013. Records were reviewed identifying those having gadolinium enhanced MRI within 1 ye...

IntroductIon Nephrogenic rests (NRs) are abnormally persistent clusters of embryonal cells, representing microscopic dysplasias of the developing kidney. NRs are found in approximately 1% of infant kidneys at autopsy. Nephroblastomatosis signifies the presence of multiple or diffuse NRs. Both NRs and nephroblastomatosis were known as precursor lesions of Wilms’ tumor.[1] Nephroblastomatosis can...

Purpose: Higher doses of gadolinium-based contrast agents (GBCA) are often used for contrast-enhanced MRA (CE-MRA). Patients with moderateto-severe (stages 3-5) chronic kidney disease undergoing contrast-enhanced MR imaging are known to be at increased risk for developing nephrogenic systemic fibrosis, particularly with higher doses or repeated exposure to GBCA (1-2). Herein we review informati...

Adequate exposure is a prerequisite for open valve surgery. The mitral valve can rarely be very challenging to expose. We describe a redo double valve replacement in a patient with nephrogenic systemic fibrosis in whom exposure of the mitral valve was achieved with cardiac autotransplantation.

In these patients, avoid use of gadolinium-based contrast agents unless the diagnostic information is essential and not available with non-contrast enhanced magnetic resonance imaging (MRI). NSF may result in fatal or debilitating systemic fibrosis affecting the skin, muscle and internal organs. Screen all patients for renal dysfunction by obtaining a history and/or laboratory tests. When admin...

Fibrotic diseases encompass a wide spectrum of clinical entities including systemic fibrotic diseases such as systemic sclerosis, sclerodermatous graft versus host disease, nephrogenic systemic fibrosis, and IgG₄-associated sclerosing disease, as well as numerous organ-specific disorders including radiation-induced fibrosis, and cardiac, pulmonary, liver, and kidney fibrosis. Although their cau...

THE PROBLEM The first case of what ultimately would be called Nephrogenic Systemic Fibrosis (NSF) was recognized in 1997 and subsequently reported in 2000.1 Over the ensuing years a growing body of literature has elucidated the clinical picture of the disease and the extent of organ involvement. Although the exact etiology remains unknown, all NSF patients have signifi cant chronic renal impair...

Nephrogenic metaplasia (or nephrogenic adenoma) and clear cell adenocarcinoma of the bladder are uncommon lesions that cause diagnostic dilemmas for pathologists due to their similar morphologic features. Nephrogenic metaplasia describes a lesion in the lower urinary tract that is composed of small tubules resembling renal medullary tubules. It has been suggested that nephrogenic metaplasia may...

Introduction: Gadolinium based contrast agents have been reported to induce nephrogenic systemic fibrosis (NSF) in patients with impaired renal function. Skin fibrosis is a characteristic symptom while the mechanism of causing NSF is unclear. In this study, we investigated the cytotoxicty Gd(III)-based contrast agents, including Omniscan®, Mutihance® and ProHance®, to normal rat skin fibroblast...

Nephrogenic systemic fibrosis (NSF) is a disease with progressive fibrosis. We describe two cases of NSF after exposure to a macrocyclic gadolinium-based contrast agent (GBCA) gadobutrol, which has been considered as a low-risk agent compared to linear GBCAs. The first case had chronic kidney disease (CKD) Stage 3 and was exposed to 17.5 ml of gadobutrol. The second case has been exposed twice ...