복막투석 환자에서 gadolinium 사용 후 발생한 콩팥성 전신성 섬유증 1예
A case of nephrogenic systemic fibrosis following gadolinium exposure in a peritoneal dialysis patient
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초록
콩팥성 전신성 섬유증은 급성 또는 만성 신부전 환자에서 gadolinium조영제를 사용하였을 경우에 생기는 질환으로 상하지 말단의 부종 후 딱딱해짐, 관절운동 장애 및 전신증상을 일으키는 질환으로 전세계적으로 증례들이 보고되고 있다. 저자들은 복막투석 환자에서 gadolinium을 사용한 자기공명영상 촬영 후 하지부종 및 통증을 동반한 nephrogenic systemic fibrosis 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Nephrogenic systemic fibrosis is a systemic illness that only affects patients with kidney failure. Exposure to gadolinium-based contrast agents has been associated with the subsequent development of nephrogenic systemic fibrosis in patients with decreased renal function. Nephrogenic systemic fibrosis is characterized by skin induration after swelling and limited joint movement through a loss in flexibility that preferentially affects the extremities. A 58-year-old man in peritoneal dialysis developed swelling and stiffness of the lower limbs following gadolinium exposure for brain magnetic resonance imaging. This patient was diagnosed with nephrogenic systemic fibrosis by CD34 immunoreactivity of subcutaneous fibroblasts in a skin biopsy. We report, for the first time in Korea, that nephrogenic systemic fibrosis developed after gadolinium exposure in a peritoneal dialysis patient.
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