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Published online before print January 31, 2007, 10.1148/radiol.2431062144
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Nephrogenic Systemic Fibrosis: Risk Factors and Incidence Estimation1

Elizabeth A. Sadowski, MD, Lindsey K. Bennett, MD, Micah R. Chan, MD, Andrew L. Wentland, BS, Andrea L. Garrett, MD, Robert W. Garrett, MD and Arjang Djamali, MD

1 From the Departments of Radiology (E.A.S., R.W.G.), Dermatology (L.K.B., A.L.G.), Medicine (M.R.C., A.D.), and Biophysics (A.L.W.), University of Wisconsin, 600 Highland Ave, Madison, WI 53792-3252. Received December 15, 2006; revision requested January 3, 2007; revision received January 10; final version accepted January 11. Address correspondence to E.A.S. (e-mail: esadowski{at}uwhealth.org).


Figure 1A
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Figure 1a: (a, b) Patient with NSF presented with area of edema, induration, and erythema on (a) the forearm and (b) an erythematous appearance to the skin over the thigh, which spared the groin. (c, d) Histopathologic photomicrographs show markedly increase cellularity with spindle-shaped fibrocytes and mucin with thickened collagen bundles that infiltrate deeply, extending into and widening the septa of the subcutaneous fat. (Hematoxylin-eosin stain; original magnification for c, x10; for d, x60.)

 

Figure 1B
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Figure 1b: (a, b) Patient with NSF presented with area of edema, induration, and erythema on (a) the forearm and (b) an erythematous appearance to the skin over the thigh, which spared the groin. (c, d) Histopathologic photomicrographs show markedly increase cellularity with spindle-shaped fibrocytes and mucin with thickened collagen bundles that infiltrate deeply, extending into and widening the septa of the subcutaneous fat. (Hematoxylin-eosin stain; original magnification for c, x10; for d, x60.)

 

Figure 1C
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Figure 1c: (a, b) Patient with NSF presented with area of edema, induration, and erythema on (a) the forearm and (b) an erythematous appearance to the skin over the thigh, which spared the groin. (c, d) Histopathologic photomicrographs show markedly increase cellularity with spindle-shaped fibrocytes and mucin with thickened collagen bundles that infiltrate deeply, extending into and widening the septa of the subcutaneous fat. (Hematoxylin-eosin stain; original magnification for c, x10; for d, x60.)

 

Figure 1D
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Figure 1d: (a, b) Patient with NSF presented with area of edema, induration, and erythema on (a) the forearm and (b) an erythematous appearance to the skin over the thigh, which spared the groin. (c, d) Histopathologic photomicrographs show markedly increase cellularity with spindle-shaped fibrocytes and mucin with thickened collagen bundles that infiltrate deeply, extending into and widening the septa of the subcutaneous fat. (Hematoxylin-eosin stain; original magnification for c, x10; for d, x60.)

 

Figure 2
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Figure 2: Chart shows 1-year incidence of NSF in patients undergoing contrast-enhanced MR (CE-MR) imaging.

 

Figure 3A
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Figure 3a: Bar graphs show relevant clinical and laboratory data in 13 patients with NSF (gray bars) and 125 control patients (white bars) without NSF but with renal insufficiency and ongoing proinflammatory condition at time of contrast-enhanced MR (CE-MR) examination. NSF group was (a) younger and (b) had significantly decreased eGFR, (c) greater sCr levels, (d), greater number of proinflammatory events, and (e) greater number of contrast-enhanced examinations per patient than did control group.

 

Figure 3B
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Figure 3b: Bar graphs show relevant clinical and laboratory data in 13 patients with NSF (gray bars) and 125 control patients (white bars) without NSF but with renal insufficiency and ongoing proinflammatory condition at time of contrast-enhanced MR (CE-MR) examination. NSF group was (a) younger and (b) had significantly decreased eGFR, (c) greater sCr levels, (d), greater number of proinflammatory events, and (e) greater number of contrast-enhanced examinations per patient than did control group.

 

Figure 3C
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Figure 3c: Bar graphs show relevant clinical and laboratory data in 13 patients with NSF (gray bars) and 125 control patients (white bars) without NSF but with renal insufficiency and ongoing proinflammatory condition at time of contrast-enhanced MR (CE-MR) examination. NSF group was (a) younger and (b) had significantly decreased eGFR, (c) greater sCr levels, (d), greater number of proinflammatory events, and (e) greater number of contrast-enhanced examinations per patient than did control group.

 

Figure 3D
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Figure 3d: Bar graphs show relevant clinical and laboratory data in 13 patients with NSF (gray bars) and 125 control patients (white bars) without NSF but with renal insufficiency and ongoing proinflammatory condition at time of contrast-enhanced MR (CE-MR) examination. NSF group was (a) younger and (b) had significantly decreased eGFR, (c) greater sCr levels, (d), greater number of proinflammatory events, and (e) greater number of contrast-enhanced examinations per patient than did control group.

 

Figure 3E
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Figure 3e: Bar graphs show relevant clinical and laboratory data in 13 patients with NSF (gray bars) and 125 control patients (white bars) without NSF but with renal insufficiency and ongoing proinflammatory condition at time of contrast-enhanced MR (CE-MR) examination. NSF group was (a) younger and (b) had significantly decreased eGFR, (c) greater sCr levels, (d), greater number of proinflammatory events, and (e) greater number of contrast-enhanced examinations per patient than did control group.

 





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