Osseous metaplasia in the setting of nephrogenic fibrosing dermopathy

Abstract

We report the exceptional finding of bone metaplasia in the setting of a case of NFD.

Nephrogenic Systemic Fibrosis Among Liver Transplant Recipients: A Single Institution Experience and Topic Update

“…The fibrotic infiltration of NSF has been described to involve a variety of tissues including subcutaneous, all muscle types, pleura and pericardium, the tunica albuginea, renal tubules, great vessels of the heart extending into the ventricles and septum, as well as facial, pulmonary and cardiac fibrosis (10). Rarely, NSF may progress to dermal calcification (2,9) and even to the extreme of osseous spicules perforating the epidermis (11). A careful histopathological evaluation and the clinically distinct characteristic distribution prevents this variant of NSF to be mistaken for calciphylaxis of renal disease.…”

New Insights into Nephrogenic Systemic Fibrosis

“…Osseous metaplasia, osteoclastlike giant cells, and calciphylaxis can be seen in some NSF biopsies. [11][12][13] On a technetium 99 -diphosphosphonate scan, areas of increased uptake can be observed in muscles. 14,15 On magnetic resonance imaging, axial T1-and fat-suppressed T2-weighted images show symmetric skin thickening and soft tissue edema.…”

Nephrogenic fibrosing dermopathy in children

“…Immunohistochemical markers such as CD34, procollagen I, CD68, and factor XIIIa have also been described as characteristic of this disorder [11,12]. Others have found that in addition to the classic histological features, dermal ossification can occur [13].…”

“…On the other hand, autoimmune phenomena have been proposed to play a possible role in the pathogenesis [13], as has the presence of "circulating cytokines" [7,15] and an aberrant recruitment, activation, or proliferation of "circulating fibrocytes" [16,17]. There is no evidence of a common etiology to the skin disorder and the associated renal abnormalities.…”