Current Rheumatology Reviews

Dr. Serena Guiducci  
Department of Biomedicine, Division of Rheumatology
University of Florence


A European View-Point on NSF

Author(s): Henrik S. Thomsen, Sameh K. Morcos.


About three and a half years ago, a causal relation between nephrogenic systemic fibrosis (NSF) and exposure to gadolinium based contrast agents (Gd-CAs) was suggested. All evidence now suggests that low stability Gd-CAs can trigger the development of NSF. All studies indicate with no exception that macrocyclic Gd-CAs release significantly less free gadolinium than the linear agents, particularly the non-ionic ones which have the highest potential of gadolinium release. The longer the Gd-CA stays in the body the larger the amount of gadolinium that is retained in the body. The magnitude of the NSF problem remains uncertain; the condition seems to be underreported. The demonstration of a link between NSF and low stability Gd-CAs has had major consequences for patients with reduced renal function. Currently, if contrast administration is clinically deemed; necessary the preferred approach is contrast enhanced MRI using a macrocyclic Gd-CA. Contrast enhanced CT is at least as risky if not more as an enhanced MRI with low stability Gd-CAs.

Keywords: Gadolinium based contrast agents, very late adverse reactions, stability, gadolinium, nephrogenic systemic fibrosis

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Article Details

Year: 2010
Page: [184 - 188]
Pages: 5
DOI: 10.2174/157339710791792757
Price: $58