Résumé
Nephrogenic systemic fibrosis (NSF) is a scleroderma-like systemic fibrosing condition of unknown etiology described in patients with renal insufficiency. Gadolinium exposure has been strongly associated with the development of NSF though the mechanism of such injury is not known. There are only few reported cases of NSF in the setting of acute renal failure and fewer reported cases where skin lesions developed after kidney function had returned to normal. We report a case of NSF in a young Hispanic woman with lupus nephritis but normal creatinine, who received gadolinium during a brief episode of prerenal acute kidney injury not requiring dialysis, secondary to sepsis.
Sujets)
Atteinte rénale aigüe/complications , Atteinte rénale aigüe/diagnostic , Adulte , Ponction-biopsie à l'aiguille , Évolution de la maladie , Femelle , Études de suivi , Gadolinium/effets indésirables , Gadolinium/diagnostic , Humains , Immunohistochimie , Tests de la fonction rénale , Glomérulonéphrite lupique/complications , Glomérulonéphrite lupique/traitement médicamenteux , Glomérulonéphrite lupique/anatomopathologie , Angiographie par résonance magnétique/effets indésirables , Angiographie par résonance magnétique/méthodes , Fibrose systémique néphrogénique/induit chimiquement , Fibrose systémique néphrogénique/anatomopathologie , Fibrose systémique néphrogénique/thérapie , Appréciation des risques , Indice de gravité de la maladieRésumé
Nephrogenic systemic fibrosis [NSF], previously known as nephrogenic fibrosing dermopathy, is an emerging systemic fibrosing disorder that develops in the setting of renal insufficiency. Nephrogenic fibrosing dermopathy [NFD] is a fibrosing condition of the skin which shows an increased number of dendritic cells, fibroblasts and thickened collagen fibers resembling scleromyxedema. It is characterized by indurated plaques mainly on the extremities and the absence of paraproteinemia. Although the exact causes of NSF have not been established, evidence suggests an association between gadoliniumbased contrast agents and development of nephrogenic systemic fibrosis. We report a patient who was under dialysis and developed NSF but she never did MRI