RESUMEN
Nephrogenic systemic fibrosis (NSF) is a progressive systemic fibrosing disease that may occur after gadolinium contrast exposure. It can lead to severe complications and even death. NSF is highly prevalent among patients with advanced chronic kidney disease (CKD). In this report, however, we describe the case of a patient with NSF that occurred during early CKD. A 65-year-old man with stage 3a CKD was transferred to our hospital because of lower extremity edema. The medical history revealed that he was exposed to gadolinium 185 days earlier, and the result of his tibial skin biopsy was consistent with NSF. The patient underwent a combined therapy with ultraviolet-A1 phototherapy and methotrexate and steroid therapy for 6 months. The combined therapy stopped the systemic progression of NSF.
Asunto(s)
Dermopatía Fibrosante Nefrogénica/diagnóstico , Insuficiencia Renal Crónica/patología , Anciano , Medios de Contraste/efectos adversos , Medios de Contraste/química , Fármacos Dermatológicos/uso terapéutico , Progresión de la Enfermedad , Gadolinio/química , Tasa de Filtración Glomerular , Humanos , Imagen por Resonancia Magnética , Masculino , Metotrexato/uso terapéutico , Dermopatía Fibrosante Nefrogénica/etiología , Dermopatía Fibrosante Nefrogénica/terapia , Índice de Severidad de la Enfermedad , Piel/patología , Terapia UltravioletaRESUMEN
In a common salt-in-polymer electrolyte, a polymer which has polar groups in the molecular chain is necessary because the polar groups dissolve lithium salt and coordinate cations. Based on the above point of view, polystyrene [PS] that has nonpolar groups is not suitable for the polymer matrix. However, in this PS-based composite polymer-in-salt system, the transport of cations is not by segmental motion but by ion-hopping through a lithium percolation path made of high content lithium salt. Moreover, Al2O3 can dissolve salt, instead of polar groups of polymer matrix, by the Lewis acid-base interactions between the surface group of Al2O3 and salt. Notably, the maximum enhancement of ionic conductivity is found in acidic Al2O3 compared with neutral and basic Al2O3 arising from the increase of free ion fraction by dissociation of salt. It was revealed that PS-Al2O3 composite solid polymer electrolyte containing 70 wt.% salt and 10 wt.% acidic Al2O3 showed the highest ionic conductivity of 9.78 × 10-5 Scm-1 at room temperature.