Fibromyalgia associated with repeated gadolinium contrast-enhanced MRI examinations

Lattanzio, Silvia Maria; Imbesi, F.

doi:10.1016/j.radcr.2020.02.002

Cited by 11 publications

(10 citation statements)

References 42 publications

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“…Among GDD-like symptoms, fatigue and mental confusion (brain fog) were the symptoms most often reported by the physicians in our sample. One recent paper (20) presented a case of fibromyalgia that emerged after exposure to GBCAs and exacerbated after additional exposures, closely resembling the signs and symptoms described in GDD. Our opinion is that the authors of that paper were reporting a case of GDD and not fibromyalgia.…”

Section: Discussionmentioning

confidence: 73%

Physicians with self-diagnosed gadolinium deposition disease: a case series

Semelka¹,

Ramalho

2021

Radiol Bras

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Objective: The objective of this study was to allow physicians with self-diagnosed gadolinium deposition disease symptoms to report their own experience. Materials and Methods: Nine physicians (seven females), with a mean age of 50.5 ± 8.3 years, participated in this case series. Nationalities were American (n = 6), British, Portuguese, and Romanian. Medical practices included internal medicine (n = 2), trauma surgery, ophthalmology, gastroenterology, psychiatry, family medicine, obstetrics/gynecology, and general practice. Results: Genetically, eight of the physicians were of central European origin. Underlying autoimmune conditions were present in four. Symptoms developed after a single injection in one physician and after multiple injections in eight. The precipitating agent was gadobenate dimeglumine in four physicians, gadobutrol in three, gadoterate meglumine in one, and gadopentetate dimeglumine in one. The most consistent symptoms were a burning sensation, brain fog, fatigue, distal paresthesia, fasciculations, headache, and insomnia. Eight of the physicians were compelled to change their practice of medicine. Conclusion: In the various physicians, gadolinium deposition disease showed common features and had a substantial impact on daily activity. Physicians are educated reporters on disease, so their personal descriptions should spark interest in further research.

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Section: Discussionmentioning

confidence: 73%

Physicians with self-diagnosed gadolinium deposition disease: a case series

Semelka¹,

Ramalho

2021

Radiol Bras

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“…The serial MRI scans show increasing hyperintensity within the dentate nucleus, potentially in keeping with Gd deposition, and the authors postulate that some or all of the patient's symptoms may have been instead related to Gd retention. 20 Fibromyalgia is a poorly understood condition, with potential triggers including dysfunction of the central and autonomic nervous systems, neurotransmitters, hormones, immune system, as well as biochemical abnormalities, external stressors, and psychiatric conditions. [21][22][23] As is the case with the patients that we have described in this article, it remains possible that the development of these nonspecific symptoms, including fatigue and generalized aches and pain, is related to the underlying pathology that required the patient to undergo the initial contrast-enhanced MRI scan.…”

Section: Discussionmentioning

confidence: 99%

“…She was ultimately diagnosed with fibromyalgia by a rheumatologist. The serial MRI scans show increasing hyperintensity within the dentate nucleus, potentially in keeping with Gd deposition, and the authors postulate that some or all of the patient's symptoms may have been instead related to Gd retention 20 . Fibromyalgia is a poorly understood condition, with potential triggers including dysfunction of the central and autonomic nervous systems, neurotransmitters, hormones, immune system, as well as biochemical abnormalities, external stressors, and psychiatric conditions 21–23 .…”

Section: Discussionmentioning

confidence: 99%

Gadolinium Concentrations in Biological Matrices From Patients Exposed to Gadolinium-Based Contrast Agents

et al. 2021

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ObjectivesThere is increasing evidence that Gd may be retained within the skin, bones, and solid organs in patients with normal renal function after exposure to Gd-based contrast agents (GBCAs). Here we present clinical data from 19 patients who requested referral to our clinical toxicology service for assessment of potential “Gd toxicity.”Materials and MethodsPatients had undergone a median of 2 (interquartile range [IQR], 1–5) exposures to GBCAs and were reviewed at a median of 5 months (IQR, 2–8 months) after the last GBCA exposure. Patients had a clinical assessment by a clinical toxicologist, and biological samples were taken in 17 patients (89.5%). Gd concentrations were measured in these samples using inductively coupled plasma mass spectrometry.ResultsAll patients had significant comorbidities, and after an extensive clinical review, none of the reported symptoms were considered likely to be related to “Gd toxicity.” Whole blood, plasma, and urine samples had detectable Gd concentrations in 69.2%, 78.6%, and 95.2% of samples, respectively. Median (IQR) concentrations of Gd were as follows: whole blood, 0.013 ng/mL (IQR, limit of detection [LOD]–0.884 ng/mL); plasma, 0.012 ng/mL (IQR, LOD–0.046 ng/mL); and spot urine, 0.304 μg/g creatinine (IQR, 0.070–3.702 μg/g creatinine). There were positive correlations between whole blood and plasma (P = 0.0024, r = 0.84), whole blood and urine (P = 0.0018, r = 0.82), and plasma and urine (P = 0.0001, r = 0.89) Gd concentrations. There was a negative correlation between Gd concentrations and the period after exposure for whole blood (P = 0.0028, r = −0.80), plasma (P = 0.0004, r = −0.86), and urine (P < 0.0001, r = −0.91).ConclusionsWe identified detectable Gd concentrations in biological matrices from all patients reporting exposure to GBCAs who were reviewed in our clinical toxicology outpatient clinic with concerns regarding potential “Gd toxicity”; however, there were no clinical features of toxicity present in this cohort. Further research is required to explore the pharmacokinetics and pharmacodynamics of GBCAs in patients with normal renal function and to determine the clinical significance of these detectable Gd concentrations.

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“…GBCAs can induce central torso and peripheral arm and leg distribution pain in patients (Semelka et al, 2016). Gadovist, a GBCA was reported to cause fibromyalgia in one patient following repeated administrations (Lattanzio and Imbesi, 2020).…”

Section: Gd Contrast Agents Are Causing Health Problemsmentioning

confidence: 99%

Toxicity of rare earth elements: An overview on human health impact

Brouziotis

Giarra

Libralato

et al. 2022

Front. Environ. Sci.

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Rare earth elements (REEs) are metals including the 15 lanthanides together with Yttrium and Scandium. China is the leading country in their exploitation and production (∼90%). REEs are necessary for the production of several technological devices. This extended use of REEs has raised concerns about human health safety. In this review, we investigated the hazard of REEs to human health and the main gaps into the knowledge like as the need to develop further focused research activity. We categorized the research papers collected into eight main sections: environmental exposure, association of REEs with health problems, exposure to REEs due to lifestyle, REE exposure through the food chain, Gd contrast agents causing health problems, occupational REE exposure, and cytotoxicity studies of REEs. This review provided information about the exposome of REEs (the exposure of REEs to the human body), the existing research data, and the gaps that require attention and must be further investigated. More than one third of the literature about REE toxicity to human health concerns their cytotoxicity to human cell lines, while hair, blood serum and blood are the most studied matrices. The main results evidenced that REEs can enter human body via several routes, are associated with numerous diseases, can cause ROS production, DNA damage and cell death, and are more toxic to cancer cells than normal cells.

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Fibromyalgia associated with repeated gadolinium contrast-enhanced MRI examinations

Cited by 11 publications

References 42 publications

Physicians with self-diagnosed gadolinium deposition disease: a case series

Physicians with self-diagnosed gadolinium deposition disease: a case series

Gadolinium Concentrations in Biological Matrices From Patients Exposed to Gadolinium-Based Contrast Agents

Toxicity of rare earth elements: An overview on human health impact

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