ABSTRACT
Nephrogenic systemic fibrosis (NSF) is a scleroderma-like systemic fibrosing condition of unknown etiology described in patients with renal insufficiency. Gadolinium exposure has been strongly associated with the development of NSF though the mechanism of such injury is not known. There are only few reported cases of NSF in the setting of acute renal failure and fewer reported cases where skin lesions developed after kidney function had returned to normal. We report a case of NSF in a young Hispanic woman with lupus nephritis but normal creatinine, who received gadolinium during a brief episode of prerenal acute kidney injury not requiring dialysis, secondary to sepsis.
Subject(s)
Acute Kidney Injury/complications , Acute Kidney Injury/diagnosis , Adult , Biopsy, Needle , Disease Progression , Female , Follow-Up Studies , Gadolinium/adverse effects , Gadolinium/diagnosis , Humans , Immunohistochemistry , Kidney Function Tests , Lupus Nephritis/complications , Lupus Nephritis/drug therapy , Lupus Nephritis/pathology , Magnetic Resonance Angiography/adverse effects , Magnetic Resonance Angiography/methods , Nephrogenic Fibrosing Dermopathy/chemically induced , Nephrogenic Fibrosing Dermopathy/pathology , Nephrogenic Fibrosing Dermopathy/therapy , Risk Assessment , Severity of Illness IndexABSTRACT
We describe a 63-year-old Afro-Caribbean female who presented with complete ophthalmoplegia of the right eye. Magnetic resonance imaging revealed a mass in the cavernous sinus, which was pathologically confirmed as due to sarcoidosis. No clinical or laboratory evidence of sarcoidosis was found in any other organs. We believe this is the first reported case of an isolated cavernous sinus syndrome due to sarcoidosis and suggest that sarcoidosis should be considered in the differential diagnosis of cavernous sinus syndromes even in the absence of systemic involvement of sarcoidosis.