åêðáéäåõóçó γ.ν.α.

Τι νεoτερο
412
στη ΝΕΦΡΟΛΟΓΙΑ
Συντονιστής: Β Χατζηκωνσταντίνου*
Νεφρογενής συστηματική ίνωση
Θ Αποστόλου
SUMMARY
xxxxxxxxx
xxxxxxxxxxxx
xxxxxxxxxxxx
APOSTOLOU T. Nephrogenic systemic fibrosis Nephrogenic Systemic Fibrosis (NSF) is a slerodermalike
condition that primary involves the skin but may also affect organs such as the liver, lung, heart
and muscle and can lead to immobility and death. The disease occurs after exposure to gadoliniumbased
contrast. The mechanism by which this occurs is not well understood. It is speculated that a
reduction in renal clearance of gadolinium increases its biological half-life and dissociation into an
ionic state. This may lead to increased tissue exposure to gadolinium, resulting in an inflammatory
reaction and fibrosis. Ever radiology examination with this contrast carries a 2.4% risk of appearance
of this entity in patients with chronic kidney disease of advanced stage. Clinically presents as a
progressive skin thickening that can involve entire body apart the face and usually occurs between
2weeks to some months after exposure to gadolinium. Often it is accompanied by pain, muscle
weakness, aggressive loss of mobility, with contractions of the joints and necessity of immobilization
and in one third of the cases can lead to a dismal outcome. There is no specific therapy so that
prevention is the only cure of the disease. Identifying patients at risk, i.e. chronic kidney disease
patients stage 4-5, patients with acute kidney failure and patients with a positive past history, and
apply alternative diagnostic radiology procedures is the best preventive measure for avoiding the
disease. Nosokomiaka Chronika, 71, Supplement, 412-415, 2009.
Key words: Nephrogenic systemic fibrosis, gadolinium, contrast nephropathy, MRI.
ΠΕΡΙΛΗΨΗ
Η νεφρογενής συστηματική ίνωση (ΝΣΙ) είναι μια νόσος που προσβάλει κατεξοχήν το δέρμα
με ομοιότητα σκληροδέρματος, χωρίς όμως να φείδεται σε κάποιες περιπτώσεις και άλλων
οργάνων όπως το ήπαρ, τον πνεύμονα, την καρδιά και τους μυς. Η νόσος εμφανίζεται μετά από
Αν. Διευθυντής, Νεφρολογικό Τμήμα, Γ.Ν.Α. «Ο Ευαγγελισμός»
*Διευθυντής, Νεφρολογικό Τμήμα Γ.Ν.Α. «Ο Ευαγγελισμός»