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Nephrogenic Systemic Fibrosis: Possible Association with a Predisposing Infection

Lauren Parks Golding1,2 and James M. Provenzale3

1 Department of Internal Medicine, Moses H. Cone Hospital, Greensboro, NC.
2 Department of Radiology, Wake Forest University, Winston-Salem, NC.
3 Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.


Figure 1
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  		Fig. 1A —Histopathologic photomicrographs of 65-year-old man (patient 2 in Table 1) who developed clinical symptoms of nephrogenic systemic fibrosis 2 months after IV administration of MR contrast material. Patient had urinary tract infection at time of contrast administration. (Courtesy of John Patrick, Greensboro, NC) H and E stain (x10 magnification) shows hypercellular dermal fibrosis and fibromucinosis.

 

Figure 2
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  		Fig. 1B —Histopathologic photomicrographs of 65-year-old man (patient 2 in Table 1) who developed clinical symptoms of nephrogenic systemic fibrosis 2 months after IV administration of MR contrast material. Patient had urinary tract infection at time of contrast administration. (Courtesy of John Patrick, Greensboro, NC) H and E stain (x60 magnification) shows increased number of delicate S-shaped and plump spindled fibroblasts and very little associated inflammation. These findings are consistent with nephrogenic systemic fibrosis.

 

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