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Gadolinium side effects have recently been linked to patients undergoing magnetic resonance imaging (MRI). Gadolinium for MRI is used to improve the visibility of internal organs and tissue so the radiologist can more easily detect anomalies. A population-based study conducted by Dr. Aneet Deo revealed that patients with renal disease (ESRD) were at greater risk for side effects of gadolinium. Nephrogenic systemic fibrosis (NSF), was found in ESRD patients after gadolinium exposure.

The study analyzed data from 467 patients on kidney dialysis due to ESRD. MR gadolinium was reported in 87 patients who underwent 123 radiological studies, the most common MRI of the abdomen and pelvis. The study was the first that strongly associated side effects of gadolinium and NSF in dialysis patients. Researchers documented cases of NSF of 4.3 per 1,000 patient years. From these initial studies, it appears that only patients with end stage renal disease (kidney disease) seem to be at risk of developing the debilitating disease skin nephrogenic systemic fibrosis (NSF).

Nephrogenic systemic fibrosis is a systemic disorder that is potentially fatal. NSF is characterized by thickening and hardening of the skin. It was first observed in 1997 when it was known as nephrogenic fibrosing dermopathy (NFD). Although the exact cause of NSF is unknown, recent studies have shown a link between NSF and patients with kidney problems after exposure to gadolinium-enhanced MRI.

The side effect NSF Gadolinium usually begins in the lower extremities, but can also develop in the diaphragm, muscles in the thigh and lower abdomen and lungs. As patients develop skin thickening that may suffer from decreased mobility of joints due to the inability to bend and straighten joints. NSF has been following the administration of the five FDA approved gadolinium contrast agents: Magnevist, MultiHance, OmniScan, OptiMARK and ProHance.

In response to the association of NSF and MRI with gadolinium, Food and Drug Administration (FDA) has issued a health alert including new warnings about fibrosis Nephrogenic systemic.
New FDA warning is for patients at risk for gadolinium side effects of NSF.

The warning includes the following box warnings and recommendations:

 • Exposure to gadolinium-based contrast agents (GBCA) increases the risk of nephrogenic systemic fibrosis (NSF) in patients with acute or chronic severe renal insufficiency or acute renal insufficiency due to hepatorenal syndrome or in the perioperative liver transplantation.

 • NSF is a debilitating and sometimes fatal disease that affects skin, muscles and internal organs.

 • Avoid use of gadolinium unless the diagnostic information is essential and regular MRI studies are not available.

 • All patients should be examined to renal dysfunction (kidney problems) by obtaining a history and if necessary laboratory tests.

 • When managing a gadolinium contrast agent, do not exceed the recommended dosage stated on the product label. Before any re-administration of gadolinium is necessary to allow sufficient time for the elimination of gadolinium.

The FDA is considering other risk management options in response to the discovery of gadolinium side effects in the patients after undergoing MRI studies. Patients are encouraged to contact their doctor immediately after receiving an MRI Gadolinium, if any of the following symptoms that may indicate the development of NSF:

The skin and eyes

 • Swelling, hardening and tightening of skin

 • Redness or dark spots on the skin

 • Burning or itching of the skin

 • Yellow raised spots on the whites of the eyes

Bones and muscles

 • Stiffness in joints, problems moving or straightening arms, hands, legs or feet

 • Pain deep in the hip bones or ribs

 • muscle weakness

The time reported between a patient undergoing an MRI with gadolinium and NSF diagnosis varies widely among patients. It can vary from days to several months. Patients with NSF can die from complications related to the disease.

Arizona Homeopathic & Integrative Medical Association (AH…

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