J Korean Med Sci.  2020 Sep;35(35):e293. 10.3346/jkms.2020.35.e293.

Late Onset Nephrogenic Systemic Fibrosis in a Patient with Stage 3 Chronic Kidney Disease: a Case Report

  • 1Division of Nephrology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
  • 2Department of Internal Medicine, Charm Clinic, Namyangju, Korea
  • 3Department of Dermatology, Hanyang University Guri Hospital, Guri, Korea
  • 4Department of Pathology, Hanyang University Guri Hospital, Guri, Korea


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.


Nephrogenic Systemic Fibrosis; Chronic Kidney Disease; Gadolinium-based Contrast Agents
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