What is gadolinium?
Gadolinium is an FDA-approved contrast agent for magnetic resonance imaging (MRI). It provides greater contrast between normal tissue and abnormal tissue in the brain and body. Gadolinium looks clear like water and is non-radioactive. After it is injected into a vein, Gadolinium accumulates in the abnormal tissue that may be affecting the body or head. Gadolinium causes these abnormal areas to become very bright (enhanced) and easy to see on the MRI.
Does gadolinium go by other names?
Gadolinium is also called gadolinium-DPTA and gadodiamide, and it goes by various brand names, depending on the pharmaceutical company that makes it:
What is the problem with gadolinium?
The FDA is evaluating a causal connection between gadolinium-containing contrast agents and a disease known as Nephrogenic Systemic Fibrosis (NSF) also called Nephrogenic Fibrosing Dermopathy (NFD) that occurs in patients with kidney failure.
Reports have identified a possible link between NSF/NFD and exposure to gadolinium containing contrast agents used at high doses for a procedure called Magnetic Resonance Angiography (MRA). An MRA test uses magnetic resonance imaging to take pictures of blood vessels. The gadolinium contrast agent is injected into a patient's vein in order to distinguish blood vessels from other nearby tissues. The 25 cases of NSF/NFD were reported on May 29, 2006, by the Danish Medicines Agency. Among these, 20 cases occurred in Denmark and five cases occurred in Austria. The patients developed NSF/SFD within 3 months (range 2 weeks to 3 months) after receiving the gadolinium-containing contrast agent.
Signs and Symptoms of NFD
Typically there is swelling and tightening of the skin, usually limited to the extremities, but sometimes involving the trunk. The condition may develop over a period of days to several weeks. In many cases, skin thickening inhibits the flexion and extension of joints, resulting in contractures. Severely affected patients may be unable to walk, or fully extend the joints of their arms, hands, legs, and feet. Complaints of muscle weakness are common. Approximately 5% of patients have a rapidly progressive (fulminant) course. The skin changes may start as reddened or darkened patches, papules, or plaques. In time, the skin may feel "woody" and the surface may resemble the texture of the peel of an orange. Patients may experience burning, itching, or severe sharp pains in areas of involvement. Radiography may reveal calcifications of the soft tissue. Deep "bone pain" has been described in the hips and in the ribs. The skin lesions are commonly symmetrical, with zones between the ankles and thighs most commonly involved, followed by involvement between the wrist and upper arms. Hand and foot swelling with blister-like lesions has also been reported. Some patients have reported yellow papules or plaques on or near the eyes. Rapid, new onset fluctuating hypertension of unknown cause has been described prior to the onset of the skin lesions.
No consistently effective treatment for NFD
There is no consistently successful treatment for NSF, although many things have been tried with varying results. Source: Cowper SE. Nephrogenic Fibrosing Dermopathy [NFD/NSF Website]. 2001-2006. Available at http://www.icnfdr.org. Accessed October 13, 2006.
Do I have a case?
If you have you have been diagnosed with NSF or NFD, you probably have a case. Please call us now! |
