Facts about Nephrogenic Systemic Fibrosis
What: Nephrogenic Systemic Fibrosis (NSF) is a rare and serious syndrome which affects the skin, eyes, joints, connective tissues and internal organs. NSF was originally called Nephrogenic Fibrosing Dermopathy, prior to knowledge of all its effects. The exact cause of NSF is not known. Nephrogenic Systemic Fibrosis was first discovered in California in 1997, and first recorded in medical texts 3 years later.

Who: Across the world, 200 cases of NSF have been recorded as of 2006. People with kidney or liver problems who receive gadolinium-based injections are at risk for developing NSF.

Following is a list of conditions which make a patient at risk for getting Nephrogenic Systemic Fibrosis:

• Acute Renal Failure
• Chronic Liver Disease
• Dialysis-dependent Chronic Renal Failure
• Kidney Insufficiency
• Liver Transplant Recipient or Expectant

In most reported NSF cases, the gadolinium was received prior to an MRI or MRA of the abdomen or pelvic area. Patients from age 24 to 64 are most commonly afflicted.

How: NSF causes fibrosis of the skin or other organs. Fibrosis is the development of excess fibrous tissue around an organ or body structure. Following is a list of organs and systems which can be affected by Nephrogenic Systemic Fibrosis:

• Skin
• Eyes
• Joints
• Bones
• Brain and Spinal Cord
• Skeletal tissue
• Kidneys
• Lungs
• Heart

When: In most cases, NSF appears two to eleven weeks after gadolinium has been received intravenously.

Nephrogenic Systemic Fibrosis Symptoms
Nephrogenic Systemic Fibrosis symptoms vary in location and time. Initial symptoms are usually in the felt in the body’s extremities and then move inward. No facial or neck symptoms have been reported. Early effects of NSF may be felt during within two weeks of receiving gadolinium-based products. Later symptoms may develop for up to 11 weeks after administration.

NSF symptoms reported are:

• Early:
  • Swelling (hands, arms, legs and/or feet)
  • Pain (bones, joints, muscles, ribs)
  • Stiffness (joints)
  • Weakness (hands, arms, legs and/or feet)
• Late:
  • Fibrosis of Skin (development of scar-like tissue)
  • Tightness or Thickness of Skin
  • Patches on skin (dark or red)
  • Discoloration of Skin
  • Pain, Itching, or Burning in affected areas
  • Stiffness (extremities)

NSF Outcome
The debilitating nature of NSF is as a result of the skin, muscle and joint tightening. This progressive tightening can lead to severe lack of range of motion, as well as extreme joint and muscle pain or skin ulcerations. Assistance in movement may ultimately be required in the form of a cane or wheelchair. In some instances, the patient may become confined to their bed.

In some of the most severe cases of NSF, multiple organs are affected. Death can result from NSF’s effect on the lungs, muscles, heart, and/or kidneys. Patients have also succumbed to liver failure and died.

Nephrogenic Systemic Fibrosis Treatment
Currently, NSF has little proven and effective treatment. Physical and UV therapy, oral medications, and liver and kidney transplants have been used in treatment of NSF with some success. Generally, the improvement of renal function can slow NSF; however, initiating dialysis after gadolinium has not been shown to effectively treat the condition. Due to the newness and rareness of NSF, professionals are hopeful that new treatments and cures are on the horizon.

If you or someone close to you has been affected with Nephrogenic Systemic Fibrosis (NSF) in California, you should contact a gadolinium lawyer immediately. The Law Firm of Greenberg & Rudman LLP has over 50 years combined experience in injury cases. Let us help you understand your rights and seek justice during this painful and difficult time. Call us now at 1-800-ALAWPRO (1-800-252-9776) for a free and confidential consultation. We are here to help you.

Please see our page on Gadolinium for more information.