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