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New study suggests cause of debilitating skin condition
Date:9/24/2007

WINSTON-SALEM, N.C. New findings from researchers at Wake Forest University Baptist Medical Center and colleagues suggest why some people with kidney failure can develop a rare tightening and swelling of the skin and other organs, including the lungs and heart.

Reporting in the October issue of the American Journal of Dermatopathology, the authors suggest a possible explanation for why some patients on kidney dialysis who are injected with a contrast agent during a magnetic resonance imaging (MRI) develop nephrogenic systemic fibrosis (NSF).

The U.S. Food and Drug Administration now requires a warning about the potential risk on the products labels. NSF leads to thickened, rough or hard skin usually on the arms, legs or trunk. In some cases, the limbs can become difficult or even impossible to move.

The cause of this syndrome has been unclear, said David C. Sane, M.D., senior researcher on the project. Our research suggests both a potential cause and the possibility of preventing or treating NSF.

Sane said the finding that an enzyme known as transglutaminase-2 (TG2) may be involved is the first to suggest how exposure to contrast agents may lead to NSF.

It has not been known what causes NSF, but a risk factor is exposure to gadolinium, an agent injected into patients veins during some MRI procedures to help improve the visibility of internal organs during the test. The condition is relatively rare it occurs in about 2 percent to 4 percent of kidney patients on dialysis who are exposed to gadolinium.

The researchers tested the hypothesis that TG2 may be involved in the response. The enzyme is found throughout the body and is involved in blood clotting and wound healing. They hypothesized that gadolinium may activate the enzyme and cause NSF.

The group obtained skin biopsies from five people with NSF and three healthy people. All NSF patients had renal failure and had previously had imaging p
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Contact: Karen Richardson
krchrdsn@wfubmc.edu
336-716-4453
Wake Forest University Baptist Medical Center
Source:Eurekalert

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