The patients reported significant improvements in subjective pain levels after TPE. Patient 1 reported decreased skin and contracture pain after the 3rd treatment, with similar results for a second series 6 months later. [ncbi.nlm.nih.gov]

Go to the pain clinic. Healthcare providers at a pain clinic can help you learn new ways to control your pain. When should I contact my healthcare provider? Your arms or legs are swollen, or you have trouble moving them. [drugs.com]

[…] may lead to or promote the disease when severe kidney disease and exposure to gadolinium-containing contrast are present include: Use of high-dose erythropoietin ( EPO ), a hormone that promotes the production of red blood cells, often used to treat anemia [mayoclinic.org]

Changes in bone marrow are likely secondary to anemia. Because of the uncommon nature of the meningeal abnormalities, the patient had a right frontal craniotomy and dural biopsy in May 2006. [ajnr.org]

The fact that these patients had significantly worse renal function as compared with most of the control subjects puts them at higher risk for requiring recombinant epoetin therapy for management of anemia. [emedicine.com]

The remaining six patients were more mildly affected (leg swellings and skin induration with/without local pain). [dx.doi.org]

A 46-year-old woman with chronic renal failure, leg swelling, and skin changes. N Engl J Med 2009;361:2166-76. [Pubmed] [40] Gibson SE, Farver CF, Prayson RA. [revistanefrologia.com]

Physical examination revealed a frail, fatigued white man who was not in acute distress. [archderm.ama-assn.org]

[…] having recognized antifibrotic properties, is a drug of particular interest that I have found most effective in my own practice, but it is a difficult drug to use on those with many comorbidities, as it leads to side effects, including fluid-shifts and fatigue [dermatologyadvisor.com]

The remaining six patients were more mildly affected (leg swellings and skin induration with/without local pain). [dx.doi.org]

NSF is characterised by skin thickening, tethering and hyperpigmentation; flexion contractures of joints; and extracutaneous fibrosis. [ncbi.nlm.nih.gov]

NSF presents with pain, pruritis, joint stiffness, tightness, swelling of the hands and feet, paraesthesias and burning. 2 Dry skin, weakness and warmth can also occur. [medsafe.govt.nz]

Characteristics include red or dark patches on the skin; burning, itching, swelling, hardening, and tightening of the skin; yellow spots on the whites of the eyes; joint stiffness with trouble moving or straightening the arms, hands, legs, or feet; pain [emedicine.com]

Within weeks, the second patient was unable to walk due to extreme muscle and joint stiffness. In 2003, this patient died from a pulmonary embolism. [ckj.oxfordjournals.org]

This patient became severely disabled from contractures and developed long bone smooth periosteal reaction, extensive intra-articular and periarticular calcifications, musculotendinous heterotopic ossification and ankylosis of several joints. [ncbi.nlm.nih.gov]

Recurrent skin thickening and tethering again improved in the patient who resumed taking imatinib mesylate for longer than 2 weeks. [ncbi.nlm.nih.gov]

NSF is characterised by skin thickening, tethering and hyperpigmentation; flexion contractures of joints; and extracutaneous fibrosis. [ncbi.nlm.nih.gov]

NSF presents with cutaneous hyperpigmentation and induration and joint contractures, but fibrosis may also develop in other organs. [ard.bmj.com]

Eventually, flexure contractures develop, with restriction to movement, pain and pruritus. [radiopaedia.org]

Many patients also noted pruritus and burning sensation in the affected skin. The clinical features of well established cutaneous lesions resembled the appearance of the cutaneous involvement of both systemic sclerosis and diffuse fasciitis. [ncbi.nlm.nih.gov]

Additionally, many patients report maddening pruritus and/or causalgia. Finally, some patients experience flexion contractures if the disorder occurs over a joint. [emedicine.com]

Southern California medical center were confronted with a mysterious clinical entity. 1,2 Several patients in their hemodialysis center began experiencing cutaneous induration and erythema of the limbs unassociated with fever, but frequently accompanied by pruritus [appliedradiology.com]

It is typically characterised by hard, erythematous and indurated skin plaques with surrounding subcutaneous oedema. Distinct papules and subcutaneous nodules can also be seen. Fibrocytes in NSF are immunohistochemically positive for CD34. [ncbi.nlm.nih.gov]

The cutaneous changes include firm and thickened, indurate skin plaques and papules on the extremities and trunk. Histopathology typically shows an increase in dermal fibroblast-like cells associated with mucin deposition. [reumatologiaclinica.org]

NSF presents with pain, pruritis, joint stiffness, tightness, swelling of the hands and feet, paraesthesias and burning. 2 Dry skin, weakness and warmth can also occur. [medsafe.govt.nz]

Rabi Yacoub, Kiran Kandukurti and Mandip Panesar, Renal Transplantation Is Associated with Improved Clinical Outcomes in Nephrogenic Systemic Fibrosis, ISRN Transplantation, 10.5402/2013/303175, 2013, (1-10), (2013). Juan L. [doi.org]

Focusing on chemical aspects leads to neglect of other important considerations in the context of NSF. [doi.org]

Nephrogenic systemic fibrosis (NSF) is a fibrosing skin disorder that develops in patients with kidney failure and has been linked to exposure to gadolinium-containing contrast agents. [ncbi.nlm.nih.gov]

Based on reported cases currently available, it appears that about 5% of those with kidney failure or kidney problems experience the systemic disorder after receiving a gadolinium agent. [bernllp.com]

Gd deposition in the cardiac tissue can be as high as in the affected skin, 43 which can lead to myocardial fibrosis. 4 Fibrosis of serous membranes, including the meninges, may also occur. 9,40,41 Systemic involvement may, therefore, lead to heart disease [doi.org]