Gadolinium used in MRI contrast agents can cause side effects ranging from nausea to fatal thickening and scarring of connective tissue. The most common side effects can occur almost immediately after receiving a gadolinium-based contrast agent and include headache, nausea and dizziness. Serious side effects of these drugs, such as gadolinium toxicity, nephrogenic systemic fibrosis (NSF) and gadolinium deposition disorder (GDD), can happen months or years after undergoing an MRI scan.
If you or a loved one suffered gadolinium toxicity after using a gadolinium-based contrast agent, you may be eligible for compensation.
Studies and adverse event reports submitted to the U.S. Food and Drug Administration link gadolinium contrast agents to side effects that involve the skin and other organs. Symptoms of gadolinium-related conditions can be severe and sometimes life-threatening.
New warnings added to the labels of gadolinium-based contrast agents (GBCAs) in 2018 say gadolinium can stay in the body for months to years after receiving these drugs during an MRI scan. The metal can build up in bone, brain and kidney tissue.
This is known as gadolinium retention. It has led to a rare condition called nephrogenic systemic fibrosis.
Gadolinium-related risks were previously thought to only affect patients with pre-existing kidney problems. But the FDA has also received reports of adverse events involving multiple organ systems in patients with normal kidney function.
Gadolinium toxicity is a side effect of gadolinium used in MRI contrast dyes.
It can occur within hours after undergoing an MRI scan with a gadolinium-based contrast agent. Or it can manifest years later in people who have gadolinium buildup in their bodies.
Gadolinium toxicity encompasses conditions such as gadolinium deposition disease (GDD) and nephrogenic systemic fibrosis (NSF).
Patients injured by GBCAs have filed gadolinium lawsuits against the drugs’ manufacturers.
Gadolinium toxicity symptoms vary from person to person. MRI contrast dye side effects may start within hours or years of receiving a GBCA. The severity ranges from mild to severe.
Linear gadolinium-based contrast agents are more likely to cause gadolinium toxicity than macrocyclic agents. These are the two types of GBCAs available in the U.S.
A 2016 study review published in Biometals suggested one linear GBCA called Omniscan caused skin lesions, fibrosis and cell swelling in rats. Scientists linked the lesions to high gadolinium concentrations in the skin, liver and femur.
Another study published in 2004 in Investigational Radiology showed Omniscan left 2.5 times more gadolinium in human bone than ProHance, a macrocyclic agent.
People who have multiple MRIs with gadolinium-based agents potentially increase the risk for toxicity.
Other patients at greater risk of gadolinium-related problems are those who are pregnant, have kidney problems, or are European-origin Caucasian women, according to a 2017 article in Applied Radiology.
Patients who may be at higher risk for gadolinium retention include pregnant women, children, patients requiring multiple lifetime doses and patients with inflammatory conditions, according to the FDA.
The main tests for gadolinium toxicity are urine and blood tests.
A 24-hour urine test may be the most reliable test for diagnosing gadolinium retention in the body, according to an article in Applied Radiology.
Few doctors understand gadolinium toxicity, and there are few methods to test for it.
The most common treatment for gadolinium toxicity or poisoning is chelation. Chelation is a process where doctors administer chelating agents to patients. These agents bind gadolinium and remove it from the body through the kidneys.
Health providers may administer chelating agents through an IV, with a pill, as a suppository under the tongue or through a rectal suppository.
Some people who suffer skin tightening, discoloration or pain take Epsom salt baths or use saunas to detoxify the skin.
Because gadolinium toxicity causes pain in the bones, skin or joints, people also use some type of pain relieving medication.
Some patients may respond to treatment involving immune system modulation. Immune modulation is using drugs or other agents to weaken or strengthen the immune system.
Gadolinium deposition disease (GDD) is a form of gadolinium toxicity. It can happen when there’s a buildup of gadolinium in the body.
GDD is a relatively newly discovered condition, and it resembles another gadolinium-related condition called nephrogenic systemic fibrosis (NSF).
NSF causes the skin and internal organs to harden in patients with pre-existing kidney issues. GDD specifically occurs in people with normal kidney function.
Scientists think people who get GDD have a genetic abnormality that makes it difficult for their bodies to get rid of heavy metals.
Diagnosis, symptoms and treatment of GDD are similar to gadolinium toxicity.
Nephrogenic systemic fibrosis (NSF) is a potentially fatal disease caused by gadolinium buildup in the body. It causes hardening and thickening of the skin and internal organs.
Researchers consider NSF to be a rare but serious side effect of GBCAs. These drugs carry a black box warning that says people with kidney problems are at risk for the disease.
The FDA first alerted the public about the link between GBCAs and nephrogenic systemic fibrosis in 2006. The agency advises against using GBCAs in certain patients with acute or chronic kidney problems.
Researchers have not reported NSF in patients with normal kidney function after receiving GBCAs.
Signs of NSF primarily involve the skin. But the debilitating disease can also damage internal organs. Organs that may be affected include the heart, kidneys, liver and lungs.
There is no cure for NSF and the condition can be deadly. The most effective treatment for NSF seems to be extracorporeal photophoresis or ECP.
In ECP, doctors collect white blood cells from a patient and expose them to radiated light. Then, they inject the cells back into the patient.
Side effects of gadolinium exposure can occur within hours, weeks or months of a GBCA injection. Mild symptoms may go away on their own. Worse symptoms may become chronic and last months or years.
The most commonly reported symptoms are headaches, bone and nerve pain, and skin thickening, according to a 2016 study in Magnetic Resonance Imaging. In the study of 42 people with symptoms, brain fog and headaches lasted for more than three months in 29 people.
People may feel minor side effects immediately after administration of GCBAs. Vomiting can occur with less than 1 in 100 injections, according to Inside Radiology. Between 1 and 4 in 100 will notice nausea or a headache.
Common side effects associated with gadolinium-based contrast agents are usually short-term and do not cause any serious health risks. They occur almost immediately after receiving the injection.
If MRI contrast side effects persist or become severe, you should speak with your doctor.
Please seek the advice of a medical professional before making health care decisions.
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