NSF/NFD (nephrogenic systemic fibrosis or nephrogenic fibrosing dermopathy) is a painful and debilitating condition which involves hardening of the skin and can cause damage to internal organs. It is caused by the use of gadolinium, used in MRI’s and MRA’s, in patients with kidney disease.
NSF/NFD was first discovered in 1997. So far it appears that only people with kidney disease develop the condition. It is rare, but very difficult to treat, and can be very painful, debilitating, and sometimes fatal. It is also preventable.
Gadolinium is a contrast agent used in magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA). A contrast agent is a dye which is injected into your body to enhance the images. Iodine-based contrast agents are known to cause acute renal failure. Gadolinium is supposed to be much safer, but in patients with kidney disease, it appears to be causing NSF/NFD.
NSF/NFD Symptoms NSF/NFD can take days or week to develop. If the condition progresses rapidly, it can be fatal. Symptoms include:
· Tightening and swelling of the skin, usually in the extremities, sometimes in the trunk of the body
· Thickening of the skin around the joints, restricting movement
· Red patches on the skin
· Skin which feels “woody" with texture similar to that of an orange peel
· Burning, itching, and/or sharp pains in affected areas
· Calcification of soft tissues
· Symmetrical skin lesions, commonly on the ankles and thighs and between the wrists and upper arms
· Muscle weakness
· Deep bone pain in the hips and ribs
· Yellow plaques near the eyes
· Fluctuating hypertension preceding the appearance of skin legions
Why Gadolinium contributes to NSF/NFD in people with kidney problems Free gadolinium is very toxic, but when used in as contrast agent it is bound to a chelate to make it safe for human use. It is removed from the body by the kidneys. When your kidneys aren’t functioning properly, you are left with high levels of gadolinium in your system.
Treating NSF/NFD Currently there is no cure for NSF/NFD, and it usually does not respond to treatment, but some patients experience partial or full recovery.
Improving kidney function can slow or stop the progression of the condition, and for some can even mean an improvement in symptoms. This can involve a kidney transplant.
Other treatment options include:
· Oral steroids
· Topical Dovonex
· Ultraviolet therapy
· Extracorporeal photopheresis (ECP)
· Plasmapheresis
· Thalidomide
· Pentoxifylline (PXF)
· Plaquenil
· Physical therapy
Each patient responds differently to different treatment options and some of the options above have serious side effects and/or cannot be used long term.
If you believe you have developed NSF, we strongly advise you to contact your physician for an examination which may involve a skin biopsy. If you are diagnosed with NSF, you should consult with an experienced pharmaceutical injury attorney. The attorneys at Burg Simpson Eldredge Hersh & Jardine, P.C. are investigating a number of claims involving victims of NSF and will represent NSF victims and their families nationwide. Please contact Burg Simpson to schedule your free confidential consultation.
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