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Study Reports Gadolinium Clearance Times for 135 Contrast MRI Cases including Agent Administered for 63 Unconfounded Cases

On December 5, 2018, Hubbs Grimm and Sharon Williams, coauthors of GadoliniumToxicity.com, released their fifth research paper on gadolinium retention from Gadolinium-based Contrast Agents (GBCAs) administered for contrast-enhanced MRIs.  The paper is titled Gadolinium Clearance Times for 135 Contrast MRI Cases and includes the contrast agents for the unconfounded cases.

Drawing on the contrast MRI history and 24-hour gadolinium urine testing results that have been received from members of the MRI-Gadolinium-Toxicity Support Group on Yahoo, the study reports retrospectively on 135 cases with 218 urine test results, including 63 unconfounded cases with 81 test results.  The participants all had normal kidney function and report having symptoms of gadolinium toxicity.  The results reported are dramatic and involve all linear and macrocyclic GBCAs currently in use in the United States.

About the Gadolinium Clearance Time Report

In addition to reporting on additional cases received since our previous paper in 2017, we now report the contrast agents received with each unconfounded case.  Analysis of the these cases produced trend lines over time that indicate typical gadolinium found in 24-hour urine testing for each of the agents including Dotarem, Gadavist, Magnevist, MultiHance, Omniscan, OptiMARK, and ProHance.  The graphs and tables provide helpful information for both patients and medical practitioners trying to understand their test results.  The analysis of clearance times for each agent is presented on a separate page.

The results show that all agents, both linear and macrocyclic, do not clear from the body in a few days as most patients are told.  None of the test results in the first 2.5 months following a contrast-enhanced MRI was within the reference range used by Mayo Clinic Laboratories.  It should be noted that the contrast agent and test result information presented is from people who believe they are suffering symptoms of gadolinium toxicity since their contrast-enhanced MRI.  It is not known whether the clearance times presented would also apply to individuals who are not symptomatic.

The complete set of test results, without any data that would identify patients, is available to other researchers upon request.

With the evidence provided that clearance times are much longer for all of the agents than expected by medical practitioners, the authors present five recommendations for needed actions by medical professionals, other researchers, government agencies, and contrast agent manufacturers.

Final Thoughts

We want to thank members of the MRI-Gadolinium-Toxicity Support Group for their willingness to share their test results and other information with us.  Our papers would not be possible without their continued support.

We urge patients, clinicians, and researchers to read the entire report and share as appropriate with your families, caregivers, and colleagues.

Read the Gadolinium Clearance Times for 135 Contrast MRI Cases Report

Hubbs Grimm and Sharon Williams

Gadolinium Toxicity – Let’s not make the same mistake again

An Editorial by Hubbs Grimm
August 2018

(A pdf of this Editorial is available for download)

I want to talk about the unfortunate results of the early studies of gadolinium toxicity that defined NSF and the parallels I see today in the effort to define Gadolinium Deposition Disease (GDD).  I will also propose an alternative view of how to describe gadolinium toxicity in a way that reflects what we currently know and do not know that will recognize all patients who have been affected by retained gadolinium.

Before I begin, I want to be clear that I believe all those who have contributed in the past and those who are contributing today are doing so with the best of intentions and working from the basis of their experience and perspective.  But that does not mean that the result or proposals are necessarily best for meeting the needs of the people who are suffering from the toxic effects of gadolinium.

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Gadolinium Toxicity: If not NSF, then what is it?

Editorial by Sharon Williams
August 2018

(A pdf of this Editorial is available for download)

What difference does a name make?  Evidently, when you are naming a disease it can make a huge difference.  The name can limit the scope of medical research, and when it comes to gadolinium, it has the potential to exclude other patient populations who have been exposed to the same toxic metal.

In 1997, when a group of patients on dialysis developed what appeared to be a new skin disorder, it was called Nephrogenic Fibrosing Dermopathy (NFD).  When researchers later learned that the problem went well beyond the patients’ skin and caused a systemic disease process, the name was changed to Nephrogenic Systemic Fibrosis (NSF).  The word “nephrogenic” in the name caused doctors and researchers to focus on people with severe renal disease.  At the beginning, that made sense since the problem only had been seen in patients with end-stage renal disease (ESRD).  Later we learned more about the cause.

In 2006, nine years after NSF/NFD was first diagnosed, the connection was made between NSF and gadolinium-based contrast agents (GBCAs) administered for MRIs.  Even though impaired kidney function did not cause NSF, the focus remained on the “N” or nephrogenic part of NSF.  Patients with normal kidney function were being overlooked; however, they were not unaffected by retained gadolinium from GBCAs.

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Preliminary report on DTPA chelation therapy to treat patients with Gadolinium Deposition Disease

The results of a chelation study using Ca-/Zn-DTPA to treat 25 patients diagnosed with Gadolinium Deposition Disease (GDD) will be published in the June 2018 issue of Investigative Radiology.  The complete article is not freely available to the public.  However, you can find the abstract of, “Intravenous Calcium-/Zinc-Diethylene Triamine Penta-Acetic Acid in Patients with Presumed Gadolinium Deposition Disease – A Preliminary Report on 25 Patients”, by Semelka et al. at https://www.ncbi.nlm.nih.gov/pubmed/29419708

According to the FDA, Calcium-DTPA (Ca-DTPA) and Zinc-DTPA (Zn-DTPA) are drug products that have been used for over 40 years to speed up excretion of the actinide elements plutonium, americium, and curium from the body.  Gadolinium (Gd) is a lanthanide series element that shares a number of chemical properties with actinides.  The purpose of the study was to determine if the FDA-approved actinide metal decorporation agents Ca-/Zn-DTPA could be beneficial for symptomatic patients with GDD who had retained gadolinium from the gadolinium-based contrast agents (GBCAs) that had been administered for their MRIs.   (more…)

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