Successful Pregnancy in a Hemodialysis Patient and Marked Resolution of Her Nephrogenic Systemic Fibrosis

Khurana, Anand; Nickel, Allan E.; Greene, John F.; Narayanan, Mohanram; High, Whitney A.; Foulks, Charles J.

doi:10.1053/j.ajkd.2007.12.037

« PreviousAmerican Journal of Kidney Diseases
Volume 51, Issue 6 , Pages e29-e32, June 2008

Successful Pregnancy in a Hemodialysis Patient and Marked Resolution of Her Nephrogenic Systemic Fibrosis

Anand Khurana, MD
- Department of Nephrology, Scott & White Clinic, Texas A&M University, Temple, TX
- Address correspondence to Anand Khurana, MD, Scott & White Memorial Hospital and Clinic, Texas A&M College of Health Sciences Center, 2401 S 31st St, Temple, TX 76508.
Allan E. Nickel, MD
- Department of Nephrology, Scott & White Clinic, Texas A&M University, Temple, TX
John F. Greene Jr, MD
- Department of Pathology, Scott & White Clinic, Texas A&M University, Temple, TX
Mohanram Narayanan, MD
- Department of Nephrology, Scott & White Clinic, Texas A&M University, Temple, TX
Whitney A. High, MD
- Department of Dermatology and Dermatopathology, University of Colorado School of Medicine, Denver, CO.
Charles J. Foulks, MD
- Department of Nephrology, Scott & White Clinic, Texas A&M University, Temple, TX

Received 27 June 2007; accepted 6 December 2007. published online 25 March 2008.

Nephrogenic systemic fibrosis (NSF) is a recently recognized clinicopathologic entity. It is believed to be related to exposure to gadolinium-containing magnetic resonance imaging agents with gadolinium deposition in the tissues, including skin and other organs. It mainly affects patients on dialysis therapy. Pregnancy in dialysis patients is a rare occurrence. We present a case of a dialysis patient who developed NSF after exposure to gadodiamide and went on to have a successful pregnancy while on hemodialysis therapy. The patient had marked clinical and histological improvement in NSF during and after her pregnancy. This also correlated with decreasing gadolinium levels in skin biopsy tissue specimens. We discuss the interplay of factors involved in the successful pregnancy and improvement in NSF lesions in this patient.

Index Words: Pregnancy, dialysis, transplantation, nephrogenic systemic fibrosis