Gadolinium-containing contrast agents
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Nephrogenic fibrosing dermopathy: case report A 48-year-old man, who had a history of end-stage renal disease on haemodialysis and hepatitis C infection, developed nephrogenic fibrosing dermopathy after receiving gadoliniumcontaining contrast agents for MRI. On 15 December 2006, the man was hospitalised for an evaluation of altered mental status and underwent an MRI of the head using gadolinium-containing contrast agents [dosage not stated]. About 1 month later, he developed painful bilateral extremity swelling with thickening of the skin of his forearms, lower legs, hands and feet; he also had some decreased range of motion of fingers and ankle joints. Dialysis was attempted to remove additional fluid, but he developed hypotension during each session. On 20 January 2007, he presented to an emergency department. The man was prescribed furosemide. However, his symptoms did not improve and, on 25 January 2007, he was admitted for evaluation of oedematous and painful hands and feet. Physical examination showed firm induration of the bilateral forearms and hands, oedema of the hands, and verrucous papules and plaques on his left forearm. Indurated, hyperpigmented plaques were observed on the bilateral lower extremities. A right arm punch biopsy was consistent with metastatic calcification with slightly increased CD34+ and factor XIIIa+ staining spindle cells and an increased mucin deposition. A right leg punch biopsy showed a significant dermal mucin with an increased CD34+ spindle cells throughout the dermis. He was diagnosed with nephrogenic fibrosing dermopathy. [Patient outcome not stated.] Lirette E, et al. Nephrogenic fibrosing dermopathy following magnetic resonance imaging with gadolinium contrast in a patient on hemodialysis. Journal of the American Academy of Dermatology 58 (Suppl. 2): 45-46 abstr. P501, No. 2, Feb 801100070 2008 [abstract] - USA
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Reactions 26 Jan 2008 No. 1186
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