Detection of iron deposition in dermal fibrocytes is a useful tool for histologic diagnosis of nephrogenic systemic fibrosis

Julia Miyamoto, Akiko Tanikawa, Atsuyuki Igarashi, Hiroshi Hataya, Ken Kobayashi, Masahiro Ikegami, Akihiro Sotome, Yayoi Nagai, Kaori Kameyama, Akira Ishiko

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8 Citations (Scopus)

Abstract

Nephrogenic systemic fibrosis (NSF) is a fibrotic disease that presents with a history of renal dysfunction. The differential diagnosis generally includes scleromyxedema, systemic sclerosis, and morphea. Especially, scleromyxedema can be extremely difficult to distinguish microscopically. Although the fibrocytes in NSF are often positive for CD34 and procollagen-I, this is not specific for NSF. We identified positive iron staining in the skin of a patient with NSF and investigated whether this was a specific feature among 9 patients with NSF reported in Japan. We found that 6 of 9 patients showed positive iron staining in the dermal fibrocytes. The amount of iron deposition seemed to have no correlation with the degree of fibrosis or duration of the skin lesions but correlated with apparent history of the use of gadolinium-based contrast agents. As controls, skin biopsies from patients with scleromyxedema, morphea, and systemic sclerosis were evaluated by iron staining. None of these control patients showed iron deposition, indicating that positive iron staining may be specific to NSF and can be a useful tool for NSF diagnosis.

Original languageEnglish
Pages (from-to)271-276
Number of pages6
JournalAmerican Journal of Dermatopathology
Volume33
Issue number3
DOIs
Publication statusPublished - 2011 May 1

Keywords

  • gadolinium
  • iron
  • magnetic resonance imaging
  • nephrogenic fibrosing dermopathy
  • renal insufficiency

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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  • Cite this

    Miyamoto, J., Tanikawa, A., Igarashi, A., Hataya, H., Kobayashi, K., Ikegami, M., Sotome, A., Nagai, Y., Kameyama, K., & Ishiko, A. (2011). Detection of iron deposition in dermal fibrocytes is a useful tool for histologic diagnosis of nephrogenic systemic fibrosis. American Journal of Dermatopathology, 33(3), 271-276. https://doi.org/10.1097/DAD.0b013e3181f63eb1