Late Onset Nephrogenic Systemic Fibrosis in a Patient with Stage 3 Chronic Kidney Disease: a Case Report
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3346/jkms.2020.35.e293
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Yu Jeong LIM
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Jisun BANG
			        		
			        		;
		        		
		        		
		        		
			        		Youngsun KO
			        		
			        		;
		        		
		        		
		        		
			        		Hyun-Min SEO
			        		
			        		;
		        		
		        		
		        		
			        		Woon Yong JUNG
			        		
			        		;
		        		
		        		
		        		
			        		Joo Hark YI
			        		
			        		;
		        		
		        		
		        		
			        		Sang-Woong HAN
			        		
			        		;
		        		
		        		
		        		
			        		Mi-yeon YU
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Division of Nephrology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Case Report
 
        	
        	
            
            
            	- From:Journal of Korean Medical Science
	            		
	            		 2020;35(35):e293-
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	 Nephrogenic systemic fibrosis (NSF) is a progressive systemic fibrosing disease that may occur after gadolinium contrast exposure. It can lead to severe complications and even death.NSF is highly prevalent among patients with advanced chronic kidney disease (CKD). In this report, however, we describe the case of a patient with NSF that occurred during early CKD. A 65-year-old man with stage 3a CKD was transferred to our hospital because of lower extremity edema. The medical history revealed that he was exposed to gadolinium 185 days earlier, and the result of his tibial skin biopsy was consistent with NSF. The patient underwent a combined therapy with ultraviolet-A1 phototherapy and methotrexate and steroid therapy for 6 months. The combined therapy stopped the systemic progression of NSF.