MRI, MRA & CT Scan Contrast Agent
Gadolinium, an element found on the periodic table, is a contrast agent that is injected into patients before MRI, MRA, and CT scans that helps make the results of these tests more visible and more easily interpreted. Gadolinium is usually safe for patients with healthy kidneys because it is removed from the body naturally; however, if the patient's kidneys are not functioning properly, gadolinium can remain in the body, causing serious harm.
Patients with kidney malfunction, patients just before or after liver transplantation, or patients with chronic liver disease receiving gadolinium are at risk for developing Nephrogenic Systemic Fibrosis (NSF) or Nephrogenic Fibrosing Dermopathy (NFD). The development of NSF is strongly related to the use of gadolinium contrast agents in MRI, MRA, and CT scans. Manufacturers and the FDA have sent out warnings about gadolinium use in patients with advanced kidney disease.
NSF can begin with thickening, tightening, and hardening of the skin with a calloused appearance. Patients can also experience burning, itching, and swelling of the skin; yellow spots on the whites of the eyes; joint stiffness and trouble moving limbs; pain deep in the hips or ribs; and muscle weakness. Skin can often have the consistency of an orange peel, can be shiny and hard to the touch, and can have a woody appearance. Yellow papules can also form on the skin. The extremities are usually first affected by the disease, followed by the trunk. The face is rarely involved. Tightening of the skin can become so severe as to constrict airways and scar internal organs, eventually causing the heart, lungs, and diaphragm to cease functioning, resulting in death.
NSF is extremely rare; currently, the FDA reports 200 cases of NSF worldwide. Because this condition is rarely reported, diagnosis errors can occur. A deep skin biopsy, such as an incisional or deep punch biopsy, is necessary to diagnose this condition. NSF is normally a chronic, progressive condition, and no cure for NSF exists at this time. Potential treatment options vary from oral steroids to physical therapy; however, each patient seems to respond differently to different treatment. Once gadolinium has entered the body, it is extremely difficult to remove in patients with decreased kidney function.
Currently, five gadolinium contrast agents made by four manufacturers are approved by the FDA: Omniscan, Margevist, OptiMARK, MultiHance, and Prohance. NSF has been reported after administration of all five Gadolinium contrast agents. Determining which contrast agent was used can be challenging, but likely can be learned from medical records.
If you have recently had an MRI and/or CT scan and have noticed symptoms of NSF, we strongly encourage you to contact your physician with your concerns. Your physician may want to schedule an examination which may include a skin biopsy. If you are diagnosed with NSF, you may have legal claims against the manufacturers of the drug for the damages you have suffered. Contacting an experienced products liability attorney is vital to your recovery in an NSF claim. At Goldenberg & Johnson, we take your health seriously; if you would like to speak to a NSF evaluator about your claim, please contact our office toll free at 1-800-279-6386.
