Gadolinium toxicity and treatment.
Gadolinium based contrast agents (GBCAs) play an important role in the diagnostic evaluation of many patients. The safety of these agents has been once again questioned after gadolinium deposits were observed and measured in brain and bone of patients with normal renal function. This retention of gadolinium in the human body has been termed "gadolinium storage condition". The long-term and cumulative effects of retained gadolinium in the brain and elsewhere are not as yet understood. Recently, patients who report that they suffer from chronic symptoms secondary to gadolinium exposure and retention created gadolinium-toxicity on-line support groups. Their self-reported symptoms have recently been published. Bone and joint complaints, and skin changes were two of the most common complaints. This condition has been termed "gadolinium deposition disease". In this review we will address gadolinium toxicity disorders, from acute adverse reactions to GBCAs to gadolinium deposition disease, with special emphasis on the latter, as it is the most recently described and least known.
Department of Radiology, University of North Carolina, Chapel Hill, NC, United States; Department of Radiology, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. Electronic address: Joana-Ramalho@netcabo.pt.
Joana
J
Ramalho
Department of Radiology, University of North Carolina, Chapel Hill, NC, United States; Department of Radiology, Hospital Garcia de Orta, Almada, Portugal. Electronic address: Miguel-ramalho@netcabo.pt.
Miguel
M
Ramalho
Division of Molecular Pharmaceutics, University of North Carolina Hospital, Chapel Hill, NC, United States. Electronic address: mjay@email.unc.edu.
Michael
M
Jay
Department of Radiology, University of North Carolina, Chapel Hill, NC, United States. Electronic address: lauren_burke@med.unc.edu.
Lauren M
LM
Burke
Department of Radiology, University of North Carolina, Chapel Hill, NC, United States. Electronic address: richsem@med.unc.edu.
Richard C
RC
Semelka
D001847:Bone Diseases / Q000139:chemically induced / Q000628:therapy; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D001921:Brain / Q000187:drug effects / Q000378:metabolism; D001927:Brain Diseases / Q000139:chemically induced* / Q000628:therapy*; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000628:therapy*; D005682:Gadolinium / Q000009:adverse effects* / Q000378:metabolism; D006801:Humans; D007592:Joint Diseases / Q000139:chemically induced / Q000628:therapy; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced* / Q000628:therapy*
D003287:Contrast Media; D005682:Gadolinium
Adverse events; Gadolinium; Gadolinium deposition disease; Toxicity; Treatment