Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis
Gadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis
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DOI：
10.1016/j.jaad.2006.10.047
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发表时间：
2007-01-01
影响因子：
13.8
通讯作者：
Cowper, Shawn E.
中科院分区：
文献类型：
--
作者：
High, Whitney A.;Ayers, Reed A.;Cowper, Shawn E.
背景：肾源性系统性纤维化（NSF）是一种病因不明的疾病，影响一部分肾功能不全患者。最近发表的文献表明暴露于含钆造影剂与随后发生NSF之间存在相关性。我们试图检测钆与NSF患者的皮肤和软组织内接触到钆为基础的contradition.Methods：石蜡包埋的技能和软组织从NSF患者接触到钆，并从阴性对照，由NSF注册（纽黑文，康涅狄格州）。使用配备有能量色散光谱的手持式发射扫描电子显微镜搜索组织中的金属。钆和其他金属的存在vas验证通过识别独特的和必要的X-射线emission spectross.Results：钆被检测到4 13个组织标本从7例记录NSF谁暴露于钆为基础的放射造影剂。在阴性对照的石蜡包埋标本中未检测到钆。根据已知的接触历史的患者可检测到的钆，组织驻留时间为4至11 months observed.Limitations：因为这是一个试点调查，只有一个单一的控制标本和一个单一的组织切片从每个组织块被利用。在这项初步研究中，在一些NSF患者的组织中检测到钆。虽然既不能确定病理生理机制，也不能证明因果关系，但NSF患者组织中钆的检测支持暴露于含钆造影剂与疾病发展之间的流行病学相关性。
Background: Nephrogenic systemic fibrosis (NSF) is a disease of unknown etiology that affects a subset of patients with renal insufficiency. Recent publication Suggested an association between exposure to gadolinium-containing contrast agents and subsequent development of NSF. We sought to detect gadolinium within the skin and soft tissue of patients with NSF who were exposed to gadolinium-based contrast.Methods: Paraffin-embedded skill and soft tissue from NSF patients exposed to gadolinium, and from negative controls, was provided by the NSF Registry (New Haven, Conn). The tissue was searched for metals using a held emission scanning electron microscope that was equipped with energy dispersive spectroscopy. The presence of gadolinium and other metals vas verified through identification of unique and requisite X-ray emission spectra.Results: Gadolinium was detected in 4 of 13 tissue specimens from 7 patients with documented NSF who were exposed to gadolinium-based radiographic contrast. No gadolinium was detected in a paraffin-embedded specimen from a negative control. Based upon the known exposure history of patients with detectable gadolinium, a tissue residence time of 4 to 11 months was observed.Limitations: As this was a pilot investigation, only a single control specimen and a single histological section from each block of tissue were utilized.Conclusion. In this pilot investigation, gadolinium was detected in the tissue of a number of patients with NSF. Although neither dispositive of a pathophysiologic mechanism, nor proof of causation, the detection of gadolinium within tissue of NSF patients is supportive of an epidemiologic association between exposure to g gadolinium-containing contrast material and development of disease.