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Nephrogenic Systemic Fibrosis: A Fibrosing Disorder Induced by Gadolinium Exposure

Elana J Bernstein, MD1, and Jonathan Kay, MD2

Nephrogenic systemic fibrosis (NSF) is an iatrogenic fibrosing disorder that primarily affects patients with chronic kidney disease in the setting of exposure to gadolinium-based contrast agents. Patients with NSF develop progressive skin hardening, tethering, and hyperpigmentation, predominantly of the extremities, as well as fixed flexion contractures due to periarticular skin tightening. This article reviews the clinical manifestations, epidemiology, histopathology, pathophysiology, and treatment of this disabling and often fatal disease. Int J Adv Rheumatol 2011;9(4):123–33.

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