Table 2. Reports of Osseous Metaplasia in Patients with Nephrogenic Systemic Fibrosis
Reference |
Age / Sex |
Origin of RF |
Duration of NSF |
Clinical Findings |
Histological Findings |
Involuting* |
Follow-up |
Ruiz-Genao et al. 2005 |
44 M |
FSGN |
5 mos |
Painful hyperkeratotic spicules on posterior legs. |
Islands and spicules of variably mineralized woven bone, parallel to and perforating the epidermal surface, containing fragment of elastic fibers, with surrounding osteoblasts and osteoclasts. |
Yes |
NA |
Wiedemeyer et al. 2009 |
56 M |
Focal glomerulo-sclerosis |
7 years |
Blotchy, red-brown macules and patches on the extremities. No induration or joint contractures. Osseous metaplasia thought to be limited to older lesions. |
Fibrosis,“elastocollagenous balls,” and osseous metaplasia in the superficial dermis, with more classic findings of NSF in the deep dermis and subcutaneous septae. |
Yes |
NA |
Deng et al. 2009 |
51 F |
HTN |
2 years |
Pruritic, pigmented firm nodules and plaques on the extremities. |
Many islands and spicules of variably mineralized woven bone in the upper and mid-dermis, widespread calcification, no osteoblasts, no osteoclasts. |
No |
NA |
Deng et al. 2009 |
20 F |
HRS |
2 mos |
Woody, pigmented plaques on the extremities. |
No |
NA |
|
Present case |
27 F |
Lupus nephritis |
7 years |
Skin-colored indurated plaques on extremities. |
Dermal fibrosis, increased fibroblasts, increased mucin, osteomas in superficial and mid-dermis, osteoblasts, no calcification. |
No |
2 years, thalidomide unsuccessful |
M – Male
F – Female
NA – Not available
mo – Months
yrs – Years
FSGN – Focal and segmental glomerulosclerosis
HRS – Hepatic-renal syndrome
HTN – Hypertension
RF – Renal failure
* Clinical or pathological evidence of involution or regressing NSF