Gadolinium Toxicity

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March 10, 2017 - European group recommends to stop using 4 linear GBCAs Read all about it.

February 27, 2017 - New Study Reports Gadolinium Retention in 70 Cases with Normal Kidney Function. Read all about it.

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Important Petition to the FDA, National Institutes of Health and others

A petition drive to Stop the Damage and Find a Cure for Victims of MRI Contrast Toxicity has been started at change.org.  The toxicity comes from the gadolinium that is retained from Gadolinium-Based Contrast Agents (GBCAs) administered for contrast-enhanced MRIs.  We hope all of our readers will sign the petition and then tell all their friends who will sign it and then tell all of their friends.  With today’s social media, we have a chance to get the attention of the FDA and other decision makers around the world.

The petition was started by MedInsight Research Institute.  https://medinsight.org/ and specifically by Moshe Rogosnitzky, the co-founder and Executive Director.  He is an established research scientist and medical innovator whose pioneering work has resulted in the development of new treatments for various types of cancer and auto-immune diseases.  We have been in touch with Moshe since late 2015 when he first contacted us about gadolinium toxicity issues.

petition-drive-pictureHis blog post announcing the petition drive “What price will we pay for the FDA’s faith in Gd?”  lays out his case for why various actions regarding the use of Gadolinium-Based Contrast Agents are needed now.  He covers many of the points we have raised and brings new insight as to why the FDA, NIH, WHO, and other organizations worldwide must Stop the Damage and Find a Cure for Victims of MRI Contrast Toxicity, the headline for the petition.

Please take action now and show your support by signing this petition at Change.org.

https://www.change.org/p/healthcare-regulators-stop-the-damage-and-find-a-cure-for-victims-of-mri-contrast-toxicity?utm_source=embedded_petition_view

Study is first to report Gadolinium Toxicity in Patients with Normal Renal Function

Presumed Gadolinium Toxicity in Subjects with Normal Renal Function – A Report of 4 Cases”, is a landmark paper which documents the first presumed cases of gadolinium toxicity.  Richard C. Semelka, MD, Radiologist at the University of North Carolina at Chapel Hill, and his colleagues are the authors.  This is the first study to describe a series of patients with normal renal function who developed symptomatology lasting beyond the immediate post-injection period after the administration of a gadolinium-based contrast agent (GBCA).

Two subjects were assessed at 2 months and at 3 months after GBCA administration (early stage), and 2 subjects were assessed at 7 years and 8 years after GBCA administration (late stage).  Clinical features were similar between subjects, and included central torso pain (all), peripheral arm and leg pain (all), clouded mentation (2), and distal arm and leg skin thickening and rubbery subcutaneous tissue (one early and both late subjects).  All subjects had evidence of gadolinium retention ranging from one month up to 8 years after disease development.

Regarding clinical findings, the authors note that “these 4 individuals showed features that resemble and are observed in NSF patients”.  “Specifically, the glove-and-sock pattern of pain (seen in all patients) is essentially universally seen in NSF, and central torso pain (seen in 3 patients) is seen with some frequency, but not universally, in NSF patients.  Skin thickening and doughiness of the hands was seen in the 2 subjects with late-stage disease and is also described as a feature that progressively develops with NSF.”  They also noted that “headache and clouded mentation are vague and non-specific clinical symptoms; but they had new onset in 2 subjects”. While numerous recent studies report gadolinium deposition in the brain, no histopathological changes have been documented yet. They point out that a compound may be neurotoxic without being associated with histopathological signs.

These clinical features are comparable to the symptomatology reported by Burke et al, in which the most common self-reported symptoms included bone/joint pain and head/neck symptoms including headache, vision change, and hearing change (77.6% each). (more…)

Gadolinium Deposition Disease – Part of a Family of Disorders

Important News for Patients who have retained gadolinium –
A recently published article by UNC Radiologist Dr. Richard Semelka and his colleagues proposes naming the histopathologically proven presence of gadolinium in brain tissue “gadolinium storage condition”, and it describes a new entity that represents symptomatic deposition of gadolinium in individuals with normal renal function, for which they propose the designation “gadolinium deposition disease”.  The article titled: Gadolinium in Humans: A Family of Disorders, was published in AJR online.

The article is not freely available to the public at this time.   Because of that, I will provide some important information from the article for patients and their doctors below.

Gadolinium Storage Condition –
“Gadolinium storage condition” is the term proposed for gadolinium tissue deposition. The authors said, “Even in patients with normal renal function, in vivo clinical exposure to gadolinium chelates results in gadolinium incorporation into body tissues such as bone matrix or brain tissues.” (See references below.)

It appears that gadolinium accumulation varies depending on the stability of the agent used.  As with NSF, the least stable GBCAs appear to be most likely to result in gadolinium storage condition, and stable agents either do not cause it or cause it at a very low level.  The clinical significance of gadolinium tissue deposition remains incompletely understood.

Gadolinium Deposition Disease –
“Gadolinium deposition disease” is the name proposed for a disease process observed in subjects with normal or near normal renal function who develop persistent symptoms that arise hours to 2 months after the administration of gadolinium-based contrast agents (GBCAs).  In these cases, no preexistent disease or subsequently developed disease of an alternate known process is present to account for the symptoms.

The authors note that some of these patients are likely to have coexistent gadolinium storage condition, as described above, but gadolinium deposition disease is also described after a single administration of GBCA.  The causal relationship has not been fully established, but it is under investigation.

The article references our MRI Gadolinium-Toxicity support group and notes that the group has reported symptoms it considers to be consistent with the known toxic effects of gadolinium.  They also cite the results of our 2014 Symptom Survey which suggests an association between chronic effects and GBCA exposure.

The authors said, in their experience, “Symptoms of gadolinium deposition disease are similar but not identical to those observed in NSF”.   They said that their preliminary investigation has convinced them that this phenomenon is a true disease process. (more…)

Toxicity of Gadolinium Deposition from MRI Contrast Agents

A recent review article by Ramalho et al summarizes the literature on gadolinium-based contrast agents or GBCAs that are administered for contrast-enhanced MRIs, and it ties together information on agent stability, and animal and human studies.  The article, “Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update”, also emphasizes that the low-stability agents are the ones most often associated with brain deposition of gadolinium that has been reported in the literature since 2014.

Since the article has Open Access at AJNR.org, I will not go into all of the details of it.  However, there are some facts contained in the paper that I want to present here that are relevant to why GadoliniumToxicity.com exists.  In 2014, Hubbs Grimm and I created this website as a way to alert people to a problem that was not yet recognized by the FDA and medical industry.  That problem was gadolinium retention in patients with normal renal function.  We knew the facts were in the published literature, but they just had not been seen by the right people yet.   Thankfully, that has now begun to change.

Nephrogenic Systemic Fibrosis (NSF)
No review of GBCAs would be complete without some background information on NSF.

In 2006, the association between the administration of GBCAs and the development of Nephrogenic Systemic Fibrosis (NSF) in patients with severe renal disease was reported by Grobner and then by Marckmann et al.  NSF predominantly involves the skin, but it is a systemic disease that may also affect other organs such as the lungs, liver, heart, and muscles.  The exact pathophysiology of NSF remains unknown, but as the review states, the dissociation of gadolinium ions from their chelating ligands has been accepted as the primary etiology.  That is more likely to occur in patients with renal failure than in those with normal renal function since the excretion rate is reduced in those with renal failure.  The article indicates that most cases of NSF reported in the literature have been associated with the administration of nonionic, linear gadodiamide (Omniscan, GE Healthcare), nonionic, linear gadoversetamide (OptiMARK, Covidien), and with ionic, linear gadopentetate dimeglumine (Magnevist, Bayer HealthCare Pharmaceuticals).

After limiting the use of GBCAs in patients with renal failure and using more stable GBCAs, there have been no new cases of NSF reported since mid-2009.  According to the paper, from 2009 to 2014, confidence in the safety of GBCAs had been largely restored.  However, since 2014, numerous studies have been published that reported finding evidence of gadolinium deposition in neural tissues in patients with normal renal function. (more…)

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