CHI-CHAO CHAOYang C.-C.Hsiao C.-H.MING-KAI PANLin C.-H.SUNG-TSANG HSIEH2020-03-022020-03-0220080929-6646https://www.scopus.com/inward/record.uri?eid=2-s2.0-42949132910&doi=10.1016%2fS0929-6646%2808%2960147-3&partnerID=40&md5=9e27557d4d448169d689b105de20f3b9https://scholars.lib.ntu.edu.tw/handle/123456789/467777Nephrogenic systemic fibrosis (NSF) is an idiopathic, progressive, systemic fibrosis that occurs in patients with renal diseases. Recently, gadolinium-containing contrast (Gd-contrast) has become a suspected causal factor for NFS. This report discusses two female patients with end-stage renal disease, aged 70 and 51 years, respectively, who developed histologically proven NSF after exposure to Gd-contrast. Clinically, both patients were characterized by fibrosis and induration of skin and muscle mainly in the limbs with joint contracture. In the first case, NSF developed gradually after undergoing evaluation by Gd-contrast magnetic resonance imaging (MRI) and subsequent surgery for her urothelial carcinoma. In the second patient, NSF developed after undergoing evaluation by Gd-contrast MRI for her right shoulder bursitis with calcification, and the conditions of NSF continued to worsen after the surgical treatment of this right shoulder lesion. Although the role of Gd-contrast in NSF is still not well known, the correlation in our cases strongly suggests that it should be used with cautioned in patients with end-stage renal disease. Both of our patients underwent surgery before or during the development of NSF, indicating that the surgical procedure may be a contributing factor. ? 2008 Elsevier & Formosan Medical Association.[SDGs]SDG3blood clotting factor 13a; carbon dioxide; CD34 antigen; CD68 antigen; gadodiamide; prednisolone; adult; aged; article; artificial ventilation; bladder carcinoma; bursitis; calcification; case report; chronic kidney failure; continuous ambulatory peritoneal dialysis; contrast enhancement; cystoscopy; elastic fiber; female; follow up; hematuria; hemodialysis; human; hyperpigmentation; hypertension; immunohistochemistry; kidney pelvis carcinoma; leg edema; limb weakness; muscle biopsy; muscle stiffness; myopathy; nephrogenic fibrosing dermopathy; nephroureterectomy; nuclear magnetic resonance imaging; physical examination; plasmapheresis; poliomyelitis; range of motion; respiratory failure; shoulder pain; skin biopsy; skin induration; skin tightness; unconsciousness; ureter carcinoma; ureteroscopy; urine volume; urogenital tract tumorjournal article10.1016/S0929-6646(08)60147-3184006142-s2.0-42949132910