Gadolinium Exposure and NSF / NFD

Gadolinium is a naturally-occurring, non-radioactive chemical element with special magnetic properties. Currently the FDA has approved five gadolinium-based substances for use during MRI (magnetic resonance imaging) scans. The use of gadolinium-based contrast agents allows doctors to obtain more detailed images because these agents temporarily accumulate in abnormal tissues throughout the body, making these areas appear illuminated on MRI scans.

Since gadolinium-enhanced MRIs were first performed in 1988, this procedure has become relatively commonplace. Until recently, it was associated with no major complications. However, in 1997 the first case of a patient developing a debilitating, progressing condition called NSF / NFD after undergoing a gadolinium-enhanced MRI was reported. After more NSF / NFD cases worldwide were linked to gadolinium exposure, the FDA in 2006 issued an official warning for healthcare professionals describing the potential dangers of gadolinium exposure. The FDA currently requires manufacturers of gadolinium-based contrast agents to put a black box warning about gadolinium side effects on their products — the strongest precaution short of a complete product recall.

Does Gadolinium Exposure Cause NSF / NFD?

So far, it has not been proved conclusively that gadolinium causes NSF / NFD. Several studies are underway to determine if and how gadolinium exposure leads to the onset of this disease. The FDA is also actively investigating whether or not the use of gadolinium-based contrast agents as part of an MRI should be restricted or banned. It is clear, however, that certain patients, including those who have kidney problems, liver transplants or have recently undergone major surgery, have a significantly higher risk of developing NSF / NFD after undergoing a gadolinium-assisted MRI. Thus, these patients should consider other diagnostic methods due to their increased risk of developing NSF / NFD after being exposed to gadolinium.

While the majority of people with healthy kidney function do not develop NSF / NFD even after multiple gadolinium-assisted MRI scans, patients with kidney problems can develop this disease even after a single gadolinium exposure. The mechanism by which gadolinium causes NSF / NFD appears to involve specific cells referred to as circulating fibrocytes. If gadolinium remains in the body for a prolonged time, it can stimulate these cells, which in turn leads to skin and tissue hardening. This abnormal cell stimulation does not usually occur in people with healthy kidneys because their kidneys eliminate gadolinium from the body relatively quickly.

Gadolinium Lawsuits