July 23, 2022

JUL 23, toxic vignette: gadolinium contrast agents for MRI (magnetic resonance imaging)

Authors' Note  Although the element gadolinium (Gd) is itself toxic, its highly bound chelates make excellent adjunctive agents for diagnostic imaging procedures using magnetic resonance (MR), as they change the magnetic properties of structures with high rates of blood flow, yet allow 'negligible' release of the metal into tissue during the interval following a single intravenous injection. Non-toxic chelates of metallic elements are normally rapidly cleared from the body by urinary excretion. 
    In the late 1990s, a  ‘new’ disease,  nephrogenic systemic fibrosis was found in a small minority of patients, mostly with severe kidney disease, who had received these contrast agents. The problem can be avoided by a simple screening of relevant patients for a history of kidney disease or renal impairment. 

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