RESUMO
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.
Assuntos
Injúria Renal Aguda/complicações , Injúria Renal Aguda/diagnóstico , Adulto , Biópsia por Agulha , Progressão da Doença , Feminino , Seguimentos , Gadolínio/efeitos adversos , Gadolínio/diagnóstico , Humanos , Imuno-Histoquímica , Testes de Função Renal , Nefrite Lúpica/complicações , Nefrite Lúpica/tratamento farmacológico , Nefrite Lúpica/patologia , Angiografia por Ressonância Magnética/efeitos adversos , Angiografia por Ressonância Magnética/métodos , Dermopatia Fibrosante Nefrogênica/induzido quimicamente , Dermopatia Fibrosante Nefrogênica/patologia , Dermopatia Fibrosante Nefrogênica/terapia , Medição de Risco , Índice de Gravidade de DoençaRESUMO
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