Richard C Semelka1, Joana Ramalho2, Ami Vakharia3, Mamdoh AlObaidy4, Lauren M Burke3, Michael Jay5, Miguel Ramalho6. 1. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. Electronic address: richsem@med.unc.edu. 2. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, Centro Hospitalar Lisboa Central, Lisbon, Portugal. 3. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. 5. Division of Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA. 6. Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal.
Abstract
PURPOSE: To describe the clinical manifestations of presumed gadolinium toxicity in patients with normal renal function. MATERIALS AND METHODS: Participants were recruited from two online gadolinium toxicity support groups. The survey was anonymous and individuals were instructed to respond to the survey only if they had evidence of normal renal function, evidence of gadolinium in their system beyond 30days of this MRI, and no pre-existent clinical symptoms and/or signs of this type. RESULTS: 42 subjects responded to the survey (age: 28-69, mean 49.1±22.4years). The most common findings were: central pain (n=15), peripheral pain (n=26), headache (n=28), and bone pain (n=26). Only subjects with distal leg and arm distribution described skin thickening (n=22). Clouded mentation and headache were the symptoms described as persistent beyond 3months in 29 subjects. Residual disease was present in all patients. Twenty-eight patients described symptoms following administration of one brand of Gadolinium-Based Contrast Agent (GBCA), 21 after a single GBCA administration and 7 after multiple GBCA administrations, including: gadopentetate dimeglumine, n=9; gadodiamide, n=4; gadoversetamide, n=4; gadobenate dimeglumine, n=4; gadobutrol, n=1; gadoteridol, n=2; and unknown, n=4. CONCLUSIONS: Gadolinium toxicity appears to arise following GBCA administration, which appears to contain clinical features seen in Nephrogenic Systemic Fibrosis, but also features not observed in that condition.
PURPOSE: To describe the clinical manifestations of presumed gadoliniumtoxicity in patients with normal renal function. MATERIALS AND METHODS:Participants were recruited from two online gadoliniumtoxicity support groups. The survey was anonymous and individuals were instructed to respond to the survey only if they had evidence of normal renal function, evidence of gadolinium in their system beyond 30days of this MRI, and no pre-existent clinical symptoms and/or signs of this type. RESULTS: 42 subjects responded to the survey (age: 28-69, mean 49.1±22.4years). The most common findings were: central pain (n=15), peripheral pain (n=26), headache (n=28), and bone pain (n=26). Only subjects with distal leg and arm distribution described skin thickening (n=22). Clouded mentation and headache were the symptoms described as persistent beyond 3months in 29 subjects. Residual disease was present in all patients. Twenty-eight patients described symptoms following administration of one brand of Gadolinium-Based Contrast Agent (GBCA), 21 after a single GBCA administration and 7 after multiple GBCA administrations, including: gadopentetate dimeglumine, n=9; gadodiamide, n=4; gadoversetamide, n=4; gadobenate dimeglumine, n=4; gadobutrol, n=1; gadoteridol, n=2; and unknown, n=4. CONCLUSIONS:Gadoliniumtoxicity appears to arise following GBCA administration, which appears to contain clinical features seen in Nephrogenic Systemic Fibrosis, but also features not observed in that condition.
Authors: Lisa B Nachtigall; Niki Karavitaki; Katja Kiseljak-Vassiliades; Luma Ghalib; Hidenori Fukuoka; Luis V Syro; Daniel Kelly; Maria Fleseriu Journal: Pituitary Date: 2019-02 Impact factor: 4.107