Symptoms
The severity of symptoms may differ from person to person, even leading to life-threatening complications in rare cases of the disease. Symptoms of NSF develop as early as the day of exposure to the gadolinium-based contrast agent (GBCA) in some people. At the other extreme, it may take as long as several months to manifest. In any case, it begins mostly as fibrosis of the skin connective tissue — a progressive thickening and hardening of the skin which might result in adherence to the underlying fascia. The distal areas of the limbs are initially affected — the wrists, ankles, fingers, and toes. Contractures of joint areas of the fingers, knees, and elbows may follow after the skin fibrosis. As the disease progresses, patients begin to have symptoms related to the internal organs, such as heart, kidney, diaphragm, lungs, etc.
It is generally chronic and as such spans a long time. Some people recover quickly from the symptoms. Commons signs and symptoms of nephrogenic systemic fibrosis include:
• Swelling of the skin, which thickens with time.
• Thickening (fibrosis) and hardening of the skin. It usually affects the arms and legs, rarely the trunk (but never on the face).
• Itchy and burning sensations in the affected areas.
• Reduced joint flexibility (due to thickening of the skin around the joints).
• Darkening of the involved areas, with skin appearing dimpled, like orange peels (peau d’orange).
• Ulcers or blisters may result, rarely. [4]
The muscles and internal organs which affected may produce additional symptoms, which include:
• Clotting of the blood.
• Pain in the bones.
• Yellowing of regions of the sclera (the white part of the eye).
• muscle weakness
• Decreased function of certain internal organs, for example, lung, heart, liver, diaphragm, and gastrointestinal tract.
• Muscle tightening around arms, feet, hands, and legs, which may limit movement around joints.
