Search

Nephrogenic systemic fibrosis (NSF) or nephrogenic fibrosing dermopathy is a rare fibrotic condition that presents in patients with a history of renal disease. The aetiology is unknown, but it has recently been proposed that gadolinium, a paramagnetic contrast agent, may be a trigger of this disease. We report three patients with NSF with a history of use of gadolinium in magnetic resonance angiography a few weeks before the onset of symptoms. In the future, gadolinium should probably be avoided as much as possible in renal insufficiency patients until its role in the development of NSF is clarified. [ABSTRACT FROM AUTHOR]

To investigate the possible relationships between blood pressure, parathyroid hormone (PTH) and platelet cytosolic Ca concentration ([Ca]) in patients with essential hypertension, we studied 17 patients with this disease aged 48±2 years and 17 normotensive controls aged 44±3 years. Platelet [Ca] was measured by spectrofluorimetry using the dye Fura-2 acetoxymethylester. Patients with essential hypertension displayed lower levels of serum ionized Ca (0.99±0.03 versus 1.1±0.01 mmol/l, <0.05) and higher serum intact PTH levels (37±3 versus 26±2 pg/ml, <0.01) than the normotensive controls. Although serum levels of intact PTH were significantly correlated with mean arterial pressure (MAP) in the combined group of subjects (=0.42, <0.05), there was no correlation when each group was considered separately. Resting platelet [Ca] was also higher in patients than in controls (57±3 versus 48±2nmol/l, <0.005). When platelets were stimulated with thrombin, the increment in [ca] was also greater in patients than in controls in the presence of extracellular Ca (264±24 versus 194±19 nmol/l, <0.05) but not in its absence (123±12 versus 112±10 nmol/l). The thrombin-induced increment in [ca] was correlated with MAP in the hypertensive patients (=0.64, <0.01) and in the combined group of subjects (=0.42, <0.05). There was no relationship between resting or thrombin-induced [Ca] and serum PTH in either group of patients or in the combined group of subjects. Furthermore, preincubation of platelets with PTH had no effect neither on resting platelet [Ca] or on thrombin-induced increments in [ca], both in the presence and in the absence of extracellular Ca in either group of subjects. Therefore, despite platelet [Ca] and serum PTH seem to be related to blood pressure, it appears that PTH does not participate directly in the elevated platelet [Ca] found in patients with essential hypertension. [ABSTRACT FROM PUBLISHER]