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Nephrogenic systemic fibrosis

Jan Endrikat, Susan Dohanish, Nicolas Schleyer, Susanne Schwenke, Sheela Agarwal, Thomas Balzer
OBJECTIVES: The aim of this study was to critically assess the evaluation and categorization process for nephrogenic systemic fibrosis (NSF) based on reports received by Bayer from 2006 to 2016. MATERIALS AND METHODS: A total of 779 NSF reports received by Bayer globally from 2006 to 2016 were included in the analysis. Arlington Medical Resources provided gadolinium-based contrast agent (GBCA) market share. Reports were conservatively categorized based on the Cowper/Girardi criteria...
March 16, 2018: Investigative Radiology
Aubrey L Galusha, Pamela C Kruger, Lyn J Howard, Patrick J Parsons
Patients receiving long-term parenteral nutrition (PN) are exposed to potentially toxic elements, which may accumulate in bone. Bone samples collected from seven PN patients (average = 14 years) and eighteen hip/knee samples were analyzed for Al as part of a previous investigation. Yttrium was serendipitously detected in the PN bone samples, leading to the present investigation of rare earth elements (REEs). A method for quantitating fifteen REEs in digested bone was developed based on tandem ICP-MS (ICP-MS/MS) to resolve spectral interferences...
May 2018: Journal of Trace Elements in Medicine and Biology
Luca Pasquini, Antonio Napolitano, Emiliano Visconti, Daniela Longo, Andrea Romano, Paolo Tomà, Maria Camilla Rossi Espagnet
In recent years, gadolinium-based contrast agents have been associated with different types of toxicity. In particular, nephrogenic systemic fibrosis, a progressive sclerotic-myxedematous systemic disease of unknown etiology, is related to gadolinium-based contrast agent administration in patients with kidney dysfunction. More recently, evidence of magnetic resonance signal intensity changes on pre-contrast T1-weighted images after multiple gadolinium-based contrast agent administrations resulted in the hypothesis of gadolinium brain accumulation in patients with normal renal function, subsequently confirmed in pathological samples...
March 5, 2018: CNS Drugs
Justyna Rogowska, Ewa Olkowska, Wojciech Ratajczyk, Lidia Wolska
Since the 1980 s, gadolinium based contrast agents (GBCA) are routinely used in magnetic resonance imaging (MRI) as stable chelates of the Gd3+ ion, without toxic effects. Generally, GBCAs are considered as some of the safest contrast agents. However, it has been observed that they can accumulate in patients tissue, bone and probably in brain (causing nephrogenic systemic fibrosis in patients with kidney failure, insufficiency and disturbance of calcium homeostasis in the organism). The GBCAs are predominantly removed renally without metabolization...
February 23, 2018: Environmental Toxicology and Chemistry
R Pullicino, K Das
Gadolinium-based contrast agents have greatly expanded the capability of magnetic resonance imaging and have been used extensively in neuroradiology over the past 30 years. When initially developed they were thought to be relatively harmless; it was later discovered they are associated with nephrogenic systemic fibrosis and should be used with caution in certain patient groups, especially those with renal failure. Lately it has been found that the use of these contrast agents may result in deposition of gadolinium in the brain even in patients with an intact blood-brain barrier...
September 2017: Journal of the Royal College of Physicians of Edinburgh
Eva Kis, Laszlo Ablonczy, György S Reusz
Early stages of chronic kidney disease (CKD) are often underdiagnosed, while their deleterious effects on the cardiovascular (CV) system are already at work. Thus, the assessment of early CV damage is of crucial importance in preventing major CV events. Myocardial fibrosis is one of the major consequences of progressive CKD, as it may lead to reentry arrhythmias and long-term myocardial dysfunction predisposing to sudden death and/or congestive heart failure. Subclinical myocardial fibrosis, with a potential key role in the development of uraemic cardiac disease, can be measured and characterised by appropriate cardiac magnetic resonance (CMR) techniques...
February 8, 2018: Kidney & Blood Pressure Research
Franco Rongioletti, Caterina Ferreli, Laura Atzori, Ugo Bottoni, Giuseppe Soda
Scleroderma is divided into a systemic form called systemic sclerosis and a localized form also called morphea. According to 2013 ACR/EULAR Classification Criteria for Systemic Sclerosis, developed by the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR), skin thickening of the fingers extending proximal to the metacarpophalangeal joints is sufficient for a patient to be classified as having scleroderma. Histological examination is not included in the diagnostic criteria and is not routinely performed...
January 24, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Michael F Tweedle
Boehm-Sturm et al ( 1 ) pose a possible paradigm shift in magnetic resonance (MR) imaging: the substitution of iron chelates for gadolinium chelates as paramagnetic contrast agents. The advent of nephrogenic systemic fibrosis challenges the wide-spread perception that gadolinium is benign, and that all gadolinium-based contrast agents (GBCAs) are identical. Long-term gadolinium retention in patients with normal renal function is now a disturbing fact. Unlike gadolinium, iron is an endogenous metal with a tightly regulated transport and storage mechanism...
February 2018: Radiology
Patrick Mark, Ilona Dekkers, Peter Blankestijn, Tim Leiner, Giles Roditi
We read with interest the guidelines recently published on sclerosing diseases of the skin (Part 2: Scleromyxedema, scleredema and nephrogenic systemic fibrosis)[1, 2]. However, we are concerned that the guideline recommendations proposed for prevention of nephrogenic systemic fibrosis (NSF) are potentially dangerous. Although we recognise the challenges in constructing comprehensive guidelines, we are concerned that this may be because the guidelines have not involved a multidisciplinary team. This article is protected by copyright...
December 28, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
Martin R Prince, Jeffrey C Weinreb
No abstract text is available yet for this article.
January 2018: Radiology
Houcine Yoldez, Blel Ahlem, Ezzeddine Abderrahim, Zeglaoui Faten, Rameh Soumaya
Nephrogenic systemic fibrosis is a rare entity occurred in patients with renal failure. It is related to toxicity to gadolinium, which is used as a contrast agent in magnetic resonance imaging. Clinic manifestations are variable. They begin by a thickening of the skin in the lower limbs and extending to the upper limbs. We report a new case of nephrogenic systemic fibrosis where cutaneous lesions begin in the upper right limb as indurated and ulcerated nodules. The diagnosis is histological.
November 24, 2017: Néphrologie & Thérapeutique
L Martí-Bonmatí, E Martí-Bonmatí
The Spanish Agency for Drugs and Healthcare Products (AEMPS), based on the recommendations of the European Committee for Risk Assessment in Pharmacovigilance, established on 13 March 2017 that linear gadolinium-based MR contrast media, such as MultiHance, Omniscan, Magnevist (currently not marketed) and Optimark (no longer marketed in Spain), the clinical benefits do not outweigh the potential risks derived from their use. AEMPS recommends to suspend its marketing for general use based on the retention of these compounds in the brain...
November 2017: Radiología
Sadichhya Lohani, Jon Golenbiewski, Abhishek Swami, Alexandra Halalau
A 57-year-old woman presented with swelling and thickening of the skin of the lower extremities. Three months prior to presentation, patient had MRI with gadolinium as part of an evaluation for suspected pancreatic malignancy. Creatinine levels at the time of gadolinium exposure were 0.9-1.2 mg/dL, with a corresponding estimated glomerular filtration rate of 64 mL/min/1.73m(2) by modification of diet in renal disease equation. Twenty-four-hour urine creatinine clearance was performed as an outpatient following development of symptoms...
October 11, 2017: BMJ Case Reports
A D Piersson, P N Gorleku
INTRODUCTION: The aim of this study is to identify current practice of administration of gadolinium-based contrast agents (GBCAs) in Ghana. METHOD: A total of 13 MRI (magnetic resonance imaging) facilities were sent a survey questionnaire to request information on their current practice with the use of GBCAs. RESULTS: Gadodiamide, a high risk GBCA accounted for 67% of first line agents. 5 (42%) had a departmental protocol on the administration of GBCAs with regards to its association with nephrogenic systemic fibrosis (NSF)...
November 2017: Radiography
Bruno P Soares, Maarten H Lequin, Thierry A G M Huisman
Iodinated and gadolinium-based contrast materials have excellent safety profiles for use in pediatric computed tomography and MR imaging. The rate of acute adverse reactions and contrast-induced nephropathy is lower than in adults. The relationship between nephrogenic systemic fibrosis and gadolinium administration is well established and only a small number of children suffer from this debilitating disorder. The recent finding of gadolinium deposition in the brain of patients with normal renal function has renewed concerns regarding its long-term toxicity...
November 2017: Magnetic Resonance Imaging Clinics of North America
Carlos A Zamora, Mauricio Castillo
Contrast agents were introduced early in the history of medical imaging. Iodine-based intravascular agents became the radiographic compounds of choice and refinements of their chemical structures led to the highly tolerated low-osmolarity agents in use today. Gadolinium became the most popular compound for MR imaging; however, recognition of nephrogenic systemic fibrosis and in vivo dechelation intensified research on their safety profile. Ultrasonography contrast media evolved from manual injections of air through agitated saline solutions to microbubbles with different gases...
November 2017: Magnetic Resonance Imaging Clinics of North America
Chuanling Wan, Rong Xue, Youyang Zhan, Yijie Wu, Xiaojing Li, Fengkui Pei
Gadolinium-based contrast agents (GBCAs) are frequently used to enhance the diagnostic efficacy of magnetic resonance imaging. On the other hand, the association between GBCA administration in patients with advanced renal disease and nephrogenic systemic fibrosis (NSF) was also noted. NSF is a systemic disorder characterized by widespread tissue fibrosis that may lead to death. N-acetylcysteine (NAC) protects rats from injury induced by gadolinium-based contrast agents, but the underlying mechanisms remain unclear...
September 2017: Omics: a Journal of Integrative Biology
Asher Street Beam, Kristi G Moore, Savannah N Gillis, Kala F Ford, Tyler Gray, Anne Howard Steinwinder, Alexa Graham
PURPOSE: To examine the risks of using of gadolinium-based contrast agents (GBCAs) in magnetic resonance (MR) imaging and explore strategies to reduce the likeliness of adverse effects in patients who might be at risk for developing nephrogenic system fibrosis (NSF). METHODS: A search of 3 scholarly databases was performed to identify articles that discuss adverse reactions to GBCAs, specifically relating to kidney function, in MR examinations. A total of 20 peer-reviewed articles were analyzed...
July 2017: Radiologic Technology
Elke Hattingen, Andreas Müller, Alina Jurcoane, Burkhard Mädler, Philip Ditter, Hans Schild, Ulrich Herrlinger, Martin Glas, Sied Kebir
SUMMARIZING THE IMPORTANCE OF THE STUDY: The repetitive usage of gadolinium-based contrast agents (GBCA) is critical for magnetic resonance imaging (MRI) evaluation of tumor burden in glioblastoma patients. It is also a crucial tool for determination of radiographical response to treatment. GBCA injection, however, comes with a 2.4% rate of adverse events including life-threatening conditions such as nephrogenic systemic fibrosis (NSF). Moreover, GBCA have been shown to be deposited in brain tissue of patients even with an intact blood-brain barrier (BBB)...
August 8, 2017: Oncotarget
Joel Rosenbloom, Edward Macarak, Sonsoles Piera-Velazquez, Sergio A Jimenez
Human fibrotic diseases constitute a major health problem worldwide owing to the large number of affected individuals, the incomplete knowledge of the fibrotic process pathogenesis, the marked heterogeneity in their etiology and clinical manifestations, the absence of appropriate and fully validated biomarkers, and, most importantly, the current void of effective disease-modifying therapeutic agents. The fibrotic disorders encompass a wide spectrum of clinical entities including systemic fibrotic diseases such as systemic sclerosis (SSc), sclerodermatous graft vs...
2017: Methods in Molecular Biology
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