title: Gadolinium deposition disease: Initial description of a disease that has been around for a while.
abstract: To describe the clinical manifestations of presumed gadolinium toxicity in patients with normal renal function.
  
  
  
  Participants were recruited from two online gadolinium toxicity support groups. The survey was anonymous and individuals were instructed to respond to the survey only if they had evidence of normal renal function, evidence of gadolinium in their system beyond 30days of this MRI, and no pre-existent clinical symptoms and/or signs of this type.
  
  
  
  42 subjects responded to the survey (age: 28-69, mean 49.1±22.4years). The most common findings were: central pain (n=15), peripheral pain (n=26), headache (n=28), and bone pain (n=26). Only subjects with distal leg and arm distribution described skin thickening (n=22). Clouded mentation and headache were the symptoms described as persistent beyond 3months in 29 subjects. Residual disease was present in all patients. Twenty-eight patients described symptoms following administration of one brand of Gadolinium-Based Contrast Agent (GBCA), 21 after a single GBCA administration and 7 after multiple GBCA administrations, including: gadopentetate dimeglumine, n=9; gadodiamide, n=4; gadoversetamide, n=4; gadobenate dimeglumine, n=4; gadobutrol, n=1; gadoteridol, n=2; and unknown, n=4.
  
  
  
  Gadolinium toxicity appears to arise following GBCA administration, which appears to contain clinical features seen in Nephrogenic Systemic Fibrosis, but also features not observed in that condition.
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA. Electronic address: richsem@med.unc.edu.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Semelka
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, Centro Hospitalar Lisboa Central, Lisbon, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Ramalho
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Ami
authors.initials: A
authors.lastname: Vakharia
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
authors.forename: Mamdoh
authors.initials: M
authors.lastname: AlObaidy
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Burke
authors.affiliation: Division of Molecular Pharmaceutics, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Jay
authors.affiliation: Department of Radiology, University of North Carolina, Chapel Hill, NC, USA; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ramalho
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D005260:Female; D005682:Gadolinium / Q000009:adverse effects* / Q000652:urine; D019786:Gadolinium DTPA / Q000009:adverse effects / Q000652:urine; D006571:Heterocyclic Compounds / Q000009:adverse effects / Q000652:urine; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000652:urine; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects / Q000652:urine; D010146:Pain / Q000139:chemically induced; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; C064572:gadobenic acid; C090600:gadobutrol; D008536:Meglumine; C064925:gadodiamide; D005682:Gadolinium; D019786:Gadolinium DTPA; C112666:gadoversetamide
keywords: Gadolinium based contrast agents; Gadolinium deposition disease; Gadolinium toxicity; NSF; Survey