Mark & Associates, P.C. Attorneys At Law

Nephrogenic Systemic Fibrosis (NSF): Hardening of the Skin After Kidney Disease Treatment

Patients with advanced kidney disease (renal failure) who have undergone an MRI or MRA with a gadolinium-based contrast agent may have developed nephrogenic system fibrosis (NSF), a rare and relatively new medical condition also called nephrogenic fibrosing dermopathy (NFD). The disease produces thickening and hardening of the skin, particularly in the arms, legs and other extremities. NSF, which was first noted in kidney disease patients in 1997, is a progressive disorder that worsens with time and can be fatal if not treated. It most often appears in middle-aged patients, although there have been cases involving children and the elderly.

In most cases, patients who develop NSF had recently received a high dose of a gadolinium-based contrast agent during an MRI examination. There are currently five FDA-approved gadolinium-based contrast agents, including:

• Magnevist (Bayer Schering Pharma)
• MultiHance (Bracco Diagnostics, Inc.)
• Omniscan (GE Healthcare)
• OptiMARK (Mallinckrodt, Inc.)
• ProHance (Bracco Diagnostics, Inc.)

It is important to note that while these contrast agents are FDA approved for use in MRI scans, they are not approved for use in MRA scans.

FDA Warnings

The U.S. Food and Drug Administration has issued several warnings and advisories about NSF in recent years. In June 2006, the agency alerted health-care professionals and the public about a possible link between NSF and specific gadolinium-based contrast agents used in MRI scans.

At that time, the agency had received reports of 90 patients with moderate to end-stage kidney disease who developed NSF following an MRI or MRA with a gadolinium-based contrast agent. The FDA said it was continuing to investigate the possible link.

In May 2007, the FDA asked manufacturers of gadolinium-based contrast agents used in MRI scans to include warnings on the product labeling to alert patients with severe kidney insufficiency who receive gadolinium-based agents about the risk for developing NSF.

NSF/NFD Symptoms

The most common symptoms of NSF are visible swelling, hardening, or tightening of the skin. The affected skin may also appear slightly discolored or leathery in areas affected by the disease.

Other common symptoms of the NSF include:

• Red or dark patches on the skin of the ankles, thighs, wrists and arms
• Blistering and swelling of the hands and feet
• Burning or itching sensations in the skin
• Yellow spots on the whites of the eyes
• Joint stiffness
• Difficulty moving the arms, hands, legs or feet
• Difficulty walking
• Pain in the hip bone or ribs
• Muscle weakness

NSF Treatment Options

Several treatment measures have proven effective in slowing the spread of NSF. The most common treatments include:

• Oral steroids
• Vascular compression
• Extracorporeal photopheresis
• Plasmapheresis
• Renal transplantation

NSF Legal Representation is Available

If you or a loved one has undergone MRI or MRA with a gadolinium contrast agent and later developed nephrogenic system fibrosis (also called nephrogenic fibrosing dermopathy), you may have rights. The experienced, aggressive personal injury attorneys at Mark & Associates, P.C. will fight for the financial compensation to which you are entitled. Contact our law firm today by completing the case submission form on this page, or by calling 1-866-50-RIGHTS (1-866-507-4448).