Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging.
Nephrogenic systemic fibrosis is a new, rare disease of unknown cause that affects patients with renal failure. Single cases led to the suspicion of a causative role of gadodiamide that is used for magnetic resonance imaging. This study therefore reviewed all of the authors' confirmed cases of nephrogenic systemic fibrosis (n = 13) with respect to clinical characteristics, gadodiamide exposure, and subsequent clinical course. It was found that all had been exposed to gadodiamide before the development of nephrogenic systemic fibrosis. The delay from exposure to first sign of the disease was 2 to 75 d (median 25 d). Odds ratio for acquiring the disease when gadodiamide exposed was 32.5 (95% confidence interval 1.9 to 549.2; P < 0.0001). Seven (54%) patients became severely disabled, and one died 21 mo after exposure. No other exposure/event than gadodiamide that was common to more than a minority of the patients could be identified. These findings indicate that gadodiamide plays a causative role in nephrogenic systemic fibrosis.
Marckmann
Peter
P
Department of Nephrology, Copenhagen University Hospital at Herlev, DK-2730 Herlev, Denmark. peter.marckmann@dadlnet.dk
Skov
Lone
L
Rossen
Kristian
K
Dupont
Anders
A
Damholt
Mette Brimnes
MB
Heaf
James Goya
JG
Thomsen
Henrik S
HS
D000328:Adult; D000368:Aged; D005260:Female; D005355:Fibrosis / Q000139:chemically induced*; D019786:Gadolinium DTPA / Q000009:adverse effects*; D005921:Glomerulonephritis / Q000175:diagnosis; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000175:diagnosis; D012871:Skin Diseases / Q000139:chemically induced*
C064925:gadodiamide; D019786:Gadolinium DTPA