On May 12, 2018, Dr. Richard Semelka revised the primary clinical diagnostic findings for Gadolinium Deposition Disease (GDD).  While the revision is being made sooner than anticipated, Dr. Semelka said it is based on well-informed recommendations from “patient experts” on the disease, and observations from 2 physician sufferers.  There are 5 symptoms that stand out to Dr. Semelka as critical diagnostic findings for GDD.  It is imperative that individuals have at least 1 of the symptoms, but he prefers to see 4/5 to make certain of the diagnosis.  Note that a 24-hour gadolinium urine test, performed 30 days or more after an MRI with a gadolinium-based contrast agent (GBCA), is still part of the diagnostic criteria for GDD.

The revised main clinical criteria for Gadolinium Deposition Disease, as described by Dr. Semelka are:

1. Intense burning of the skin and skin substrate.Arising in early stage (early on after GBCA): This can be an all over feeling in the body, but often may be localized to the trunk region or distal extremities.
2. Intense boring pain in bones or joints. Arising in early stage (early on after GBCA): This can be any bones or any joints. Often the joints may be peripheral but can also be large joints like the knee or hip. Any bones can have severe point pain, but rib pain is quite distinctive for the disease.
3. Brain fog. Arising in early stage (early on after GBCA): Many terms have been used for this: mental confusion sounds more scientific, but brain fog gets the point across well and succinctly.
4. Muscle vibrations (muscle fasciculations) and skin pins and needles/tingling (early on after GBCA). These symptoms may represent part of the same process that is causing brain fog. Muscle vibrations/twitching and pins and needles skin sensations generally reflect nerve disease (neuropathy).
5. Distal arm and leg skin/skin substrate thickening, discoloration, and pain. Arising in the subacute stage (2 weeks +): This is very much like the principal features of NSF, but generally less severe. Instead of woodiness, doughiness; instead of redness, pinkness; instead of extreme joint contractures, stiffness of joints and decreased range of motion. This symptom complex should be expected.

More details of the 5 primary clinical diagnostic findings for GDD can be found on Dr. Semelka’s Blog page of his website: https://www.richardsemelka.com/

While the clinical criteria for GDD has been revised sooner than anticipated, Dr. Semelka noted that it is important to remember how criteria and described risks for NSF (nephrogenic systemic fibrosis) were revised over several years.  The name was also changed from NFD (nephrogenic fibrosing dermopathy) to NSF when it was determined that retained gadolinium caused a systemic disease process and not just skin changes as originally thought.

My thoughts –
I think it is important to mention that as of this writing, Gadolinium Deposition Disease has not been officially recognized by the medical community and FDA.  However, regardless of what it is called, it is evident that gadolinium retained from MRI contrast agents is causing a wide range of chronic symptoms in people with normal renal function.  How many people have been adversely affected by gadolinium toxicity is currently unknown.

Sharon Williams
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