Metal deposition in calcific uremic arteriolopathy

Abstract

Background Calcific uremic arteriolopathy (CUA) is an often fatal disease that affects patients with end stage renal disease. Although animal studies support a role for metals in the pathogenesis of CUA, metal accumulation in human tissue has not been previously evaluated. Objective To evaluate metal deposition in CUA. Methods Twelve histologically proven cases of CUA were identified from the UAMS dermatopathology database. Five skin biopsies from chronic kidney disease patients exposed to gadolinium contrast but without CUA were used as controls. Quantification of metals including iron, aluminum and gadolinium in the lesional skin was performed using inductively coupled mass spectrometry. Results Seven patients had documented exposure to gadolinium-based contrast in the preceding 2 years before CUA. Three of them had concurrent nephrogenic systemic fibrosis. Highly significant quantities of iron (p=0.03), and aluminum (p=0.0002) were detected in CUA specimens compared to controls. Significant amounts of gadolinium were present in several CUA biopsies. Limitations Observational, retrospective study design and small sample size. Conclusion Tissue iron and aluminum content is increased in CUA. A significant amount of gadolinium is also present in some CUA specimens. Based on animal studies which strongly implicate metals in the pathogenesis of CUA, our data suggest that metal deposition should be considered in the pathogenesis of human CUA.

Synthesis of Multicolor Core/Shell NaLuF4:Yb3+/Ln3+@CaF2 Upconversion Nanocrystals

“…A straightforward approach is to grow a homogenous core/shell structure where the host of the shell is identical to the core [37,43]. However, the possible leaking of rare earth ions from the host lattice could possibly lead to diseases such as nephrogenic systemic fibrosis [44,45]. Compared with lanthanide fluorides, calcium fluoride (CaF 2 ) has unique advantages owing to its superior biocompatibility and high optical transparency [46,47,48,49,50,51].…”

Localized chrysiasis, aluminum salt deposition and dystrophic calcification a decade after gold injections

“…8 -10,13 Aluminum deposition in the skin has also been previously described in renal transplant patients undergoing dialysis. 17 The histopathologic findings in these patients, however, showed different pathology including calcific uremic arteriopathy (calciphylaxis), nephrogenic systemic fibrosis or were quantitative studies of metal deposition in the skin only.…”

“…In these examples of granulomatous reactions to aluminum, microscopic evaluation shows a characteristic finely granular, blue‐gray appearance to the cytoplasm of histiocytes within the dermis at the sites of metal deposition . Aluminum deposition in the skin has also been previously described in renal transplant patients undergoing dialysis . The histopathologic findings in these patients, however, showed different pathology including calcific uremic arteriopathy (calciphylaxis), nephrogenic systemic fibrosis or were quantitative studies of metal deposition in the skin only.…”

Quantitative analysis of toxic and essential elements in human hair. Clinical validity of results

“…The complexity of metal transport, ion import into, and export from cells is controlled by systems responsible for the maintenance of an appropriate metal ion homeostasis inside the cell and between different cellular compartments. Disturbed metal trafficking has been implicated in a range of human diseases (Lalla et al 2009;Koizumi et al 2008;Seppanen et al 2004;Amuluru et al 2009). …”