Sodium thiosulfate for treatment of nephrogenic systemic fibrosis with metastatic pulmonary calcification in a patient undergoing peritoneal dialysis: a case report

Nephrogenic systemic fibrosis (NSF) is a rare systemic disease characterized by widespread, progressive fibrosis of the skin and connective tissue. We report a rare case of NSF and metastatic pulmonary calcification coexisting in a patient undergoing peritoneal dialysis (PD). The patient had received two exposures to gadodiamide 11 weeks prior to admission. Subsequently, he developed skin sclerosis in the lower limbs, which gradually spread to the waist and back, accompanied by limited joint movement in the lower extremities, resulting in an inability to walk. After the patient was ​transitioned​​ to hemodialysis, received low-dose methylprednisolone and intravenous sodium thiosulfate, and underwent infrared radiation therapy, his skin sclerosis and limited joint movement ​​improved significantly, indicating that the treatment was effective.