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dc.contributor.authorLyapustina, Tatyana
dc.contributor.authorGoldfine, Charlotte
dc.contributor.authorRhyee, Sean Hyun
dc.contributor.authorBabu, Kavita M.
dc.contributor.authorGriswold, Matthew K.
dc.date2022-08-11T08:08:17.000
dc.date.accessioned2022-08-23T15:49:36Z
dc.date.available2022-08-23T15:49:36Z
dc.date.issued2018-11-29
dc.date.submitted2018-12-05
dc.identifier.citation<p>J Med Toxicol. 2018 Nov 29. doi: 10.1007/s13181-018-0689-x. [Epub ahead of print] <a href="https://doi.org/10.1007/s13181-018-0689-x">Link to article on publisher's site</a></p>
dc.identifier.issn1556-9039 (Linking)
dc.identifier.doi10.1007/s13181-018-0689-x
dc.identifier.pmid30499040
dc.identifier.urihttp://hdl.handle.net/20.500.14038/28474
dc.description.abstractINTRODUCTION: Gadolinium-based contrast agents (GBCAs) have been increasingly used in clinical practice since their introduction in the 1980s. Recently, increased public attention has been given to patients who report new symptoms following GBCA exposure. This review details the current knowledge surrounding GBCAs, with a focus on the known and proposed disease states that may be associated with GBCAs. Recommendations for the appropriate clinical workup of a patient suspected of having symptoms attributable to gadolinium exposure are included. DISCUSSION: GBCAs are known to precipitate the disease state nephrogenic systemic fibrosis (NSF), a syndrome characterized by skin thickening in patients with preexisting renal disease. An additional syndrome, termed gadolinium deposition disease, has been proposed to describe patients with normal renal function who develop an array of symptoms following GBCA exposure. While there is a potential physiologic basis for the development of this condition, there is no conclusive evidence to support a causal relationship between GBCA administration and the reported symptoms yet. Clinical evaluation revolves around focused history-taking and physical examination, given the absence of a reliable link between patient symptoms and measured gadolinium levels. There are no recommended treatments for suspected gadolinium deposition disease. Chelation therapy, which is not approved for this indication, carries undue risk without documented efficacy. CONCLUSIONS: The extent to which GBCAs contribute to clinically relevant adverse effects remains an important and evolving field of study. NSF remains the only proven disease state associated with GBCA exposure. Additional data are required to evaluate whether other symptoms should be attributed to GBCAs.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30499040&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://doi.org/10.1007/s13181-018-0689-x
dc.subjectGadolinium
dc.subjectGadolinium deposition disease
dc.subjectGadolinium-based contrast
dc.subjectMagnetic resonance imaging
dc.subjectNephrogenic systemic fibrosis
dc.subjectDiagnosis
dc.subjectEmergency Medicine
dc.subjectInorganic Chemicals
dc.subjectMedical Toxicology
dc.subjectPathological Conditions, Signs and Symptoms
dc.titleEvaluating the Patient with Reported Gadolinium-Associated Illness
dc.typeJournal Article
dc.source.journaltitleJournal of medical toxicology : official journal of the American College of Medical Toxicology
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/emed_pp/164
dc.identifier.contextkey13424023
html.description.abstract<p>INTRODUCTION: Gadolinium-based contrast agents (GBCAs) have been increasingly used in clinical practice since their introduction in the 1980s. Recently, increased public attention has been given to patients who report new symptoms following GBCA exposure. This review details the current knowledge surrounding GBCAs, with a focus on the known and proposed disease states that may be associated with GBCAs. Recommendations for the appropriate clinical workup of a patient suspected of having symptoms attributable to gadolinium exposure are included.</p> <p>DISCUSSION: GBCAs are known to precipitate the disease state nephrogenic systemic fibrosis (NSF), a syndrome characterized by skin thickening in patients with preexisting renal disease. An additional syndrome, termed gadolinium deposition disease, has been proposed to describe patients with normal renal function who develop an array of symptoms following GBCA exposure. While there is a potential physiologic basis for the development of this condition, there is no conclusive evidence to support a causal relationship between GBCA administration and the reported symptoms yet. Clinical evaluation revolves around focused history-taking and physical examination, given the absence of a reliable link between patient symptoms and measured gadolinium levels. There are no recommended treatments for suspected gadolinium deposition disease. Chelation therapy, which is not approved for this indication, carries undue risk without documented efficacy.</p> <p>CONCLUSIONS: The extent to which GBCAs contribute to clinically relevant adverse effects remains an important and evolving field of study. NSF remains the only proven disease state associated with GBCA exposure. Additional data are required to evaluate whether other symptoms should be attributed to GBCAs.</p>
dc.identifier.submissionpathemed_pp/164
dc.contributor.departmentDepartment of Emergency Medicine


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