Metal deposition in calcific uremic arteriolopathy

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:61

Article

Amuluru, Lavanya¹  High, Whitney³  Hiatt, Kim M.²  Ranville, James⁴  Shah, Sudhir V.¹  Malik, Bilal¹  Swaminathan, Sundararaman¹ 

[1] Univ Arkansas Med Sci, Div Nephrol, Little Rock, AR 72205 USA

[2] Univ Arkansas Med Sci, Dept Pathol & Dermatol, Little Rock, AR 72205 USA

[3] Univ Colorado, Hlth Sci Ctr, Dept Dermatol, Denver, CO USA

[4] Colorado Sch Mines, Golden, CO 80401 USA

关键词: calcific uremic arteriolopathy;    calciphylaxis;    gadolinium;    metals;    nephrogenic systemic fibrosis;   

DOI  :  10.1016/j.jaad.2009.01.042

来源: Elsevier

【 摘 要 】

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. We Sought to evaluate metal deposition in CUA. Methods: Twelve histologically proven cases of CUA were identified from our dermatopathology database. Five skin biopsy specimens from patients with chronic kidney disease 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 2 years before CUA. Three of them had concurrent nephrogenic systemic fibrosis. Highly significant quantities of iron (P = .03) and aluminum (P = .0002) were detected in CUA specimens compared with controls. Significant amounts of gadolinium were present in several CUA biopsy specimens. Limitations: Observational, retrospective study design and small sample size are limitations. 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 that strongly implicate metals in the pathogenesis of CUA, our data Suggest that metal deposition should be considered in the pathogenesis of human CUA. (J Am Acad Dermatol 2009;61:73-9.)

【 授权许可】

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