Quantification of gadolinium in fresh skin and serum samples from patients with nephrogenic systemic fibrosis - 10/08/11
, Matthew M. Hanley, MS c, Nelson Leung, MD d, Thomas P. Moyer, PhD c, Mark R. Pittelkow, MD e
Reprint requests: Christine U. Lee, MD, PhD, Mayo Clinic, 200 First St SW, Rochester, MN 55905.Abstract |
Background |
Nephrogenic systemic fibrosis (NSF) is a rare, potentially fatal fibrosing disorder associated with renal insufficiency and gadolinium (Gd)-based contrast exposure. The cause remains unknown. To date, all efforts to investigate skin Gd concentrations in patients with NSF have been performed on paraffin-embedded samples, and Gd deposition has not been correlated with disease activity by a statistically significant analysis.
Objective |
We sought to: (1) quantify Gd concentration in fresh tissue skin biopsy specimens; (2) quantify and compare synchronous Gd concentration of affected skin and unaffected skin in patients with NSF (n = 13) with a control group (n = 13); and (3) quantify serum Gd.
Methods |
We used inductively coupled plasma mass spectrometry.
Results |
In patients with NSF, the mean ratio of paired Gd concentrations of affected skin to unaffected skin was 23.1, ranging from 1.2 to 88.9. Mean serum Gd concentrations in patients with NSF were 4.8 ng/mL, which is more than 10 times the level in control patients. A statistically significant correlation existed between serum and affected skin Gd concentrations (r2 = .74, P < .0001).
Limitations |
Because of the feasibility of this study, the main limitation was the small sample size (n = 13 affected and 13 control).
Conclusions |
Determination of Gd concentrations in fresh skin samples and serum using inductively coupled plasma mass spectrometry demonstrates significant differences in the amounts of Gd in involved versus nonlesional skin of patients with NSF. This supports the role of differential free Gd deposition from Gd-based contrast in the pathogenesis of NSF.
Le texte complet de cet article est disponible en PDF.Key words : gadolinium, inductively coupled plasma mass spectroscopy, nephrogenic systemic fibrosis, serum, skin biopsy
Abbreviations used : AS, GBCA, Gd, ICP-MS, NSF, US
Plan
| The American Dermatologic Association Inc provided sponsorship and support of Kevin Christensen with a 2009 Medical Student Fellowship Award. |
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| Conflicts of interest: None declared. |
Vol 64 - N° 1
P. 91-96 - janvier 2011 Retour au numéro
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