Nephrogenic systemic fibrosis: Suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging
Nephrogenic systemic fibrosis: Suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging
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DOI：
10.1681/asn.2006060601
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发表时间：
2006-09-01
影响因子：
13.6
通讯作者：
Thomsen, Henrik S.
中科院分区：
文献类型：
--
作者：
Marckmann, Peter;Skov, Lone;Thomsen, Henrik S.
肾源性全身性纤维化是一种新的、病因不明的罕见疾病，主要影响肾功能衰竭患者。单个病例导致了对用于磁共振成像的gadodiamide的致病作用的怀疑。因此，本研究回顾了所有作者确认的肾源性系统性纤维化病例（n = 13），包括临床特征、加多二胺暴露和随后的临床病程。结果发现，在肾源性全身性纤维化发生之前，所有患者都曾暴露于加多二胺。从接触到首次出现疾病体征的延迟时间为2至75天（中位数为25天）。gadodiamide暴露后患病的优势比为32.5（95%可信区间1.9 ~ 549.2;P < 0.0001）。7例（54%）患者严重致残，1例在接触后21个月死亡。除了加多二胺外，没有其他暴露/事件在少数患者中是常见的。这些发现表明加多二胺在肾源性全身性纤维化中起致病作用。
Nephrogenic systemic fibrosis is a new, rare disease of unknown cause that affects patients with renal failure. Single cases led to the suspicion of a causative role of gadodiamide that is used for magnetic resonance imaging. This study therefore reviewed all of the authors' confirmed cases of nephrogenic systemic fibrosis (n = 13) with respect to clinical characteristics, gadodiamide exposure, and subsequent clinical course. It was found that all had been exposed to gadodiamide before the development of nephrogenic systemic fibrosis. The delay from exposure to first sign of the disease was 2 to 75 d (median 25 d). Odds ratio for acquiring the disease when gadodiamide exposed was 32.5 (95% confidence interval 1.9 to 549.2; P < 0.0001). Seven (54%) patients became severely disabled, and one died 21 mo after exposure. No other exposure/event than gadodiamide that was common to more than a minority of the patients could be identified. These findings indicate that gadodiamide plays a causative role in nephrogenic systemic fibrosis.