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Law Offices of Thomas J. Lamb

Contrast Agents And Gadolinium Deposition Disease: Medical Literature Review, September 2018 – February 2019

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We continue to monitor the medical literature for developments related to gadolinium retention in connection with our investigation of cases of Gadolinium Deposition Disease (GDD) in patients who received injections of gadolinium based contrast agents for their MRI, MRA, or CT scan procedure.

Presented below is a collection of medical articles published in the past six months — September 2018 to March 2019 — written by or about medical researchers investigating the extent and severity of gadolinium retention following injections of gadolinium-based contrast agents for MRIs, MRAs, and CT scans.

  • “Safety of Gadolinium Administration in Children”, from Pediatric Neurology medical journal (September 2018 edition) — Abstract
  • “How widespread is gadolinium accumulation in the brain?”, an AuntMinnie.com news report (October 31, 2018) — Preview of November 28, 2018 scientific sessions at the annual RSNA show
  • “Long-term Excretion of Gadolinium-based Contrast Agents: Linear versus Macrocyclic Agents in an Experimental Rat Model”, from Radiology medical journal (Published Online: November 13, 2018) — Abstract
  • “Gadolinium retention in gliomas and adjacent normal brain tissue: association with tumor contrast enhancement and linear/macrocyclic agents”, from Neuroradiology medical journal (First Online: February 2, 2019) — Abstract

For more about Gadolinium Deposition Disease (GDD) in patients, which is a form of gadolinium toxicity and sometimes called, instead, Gadolinium Storage Condition, see our Gadolinium Based Contrast Agents Side Effects page.

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May 2018 Gadolinium Deposition Disease Update Issued By Health Canada

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In May 2018 Health Canada announced the results of its second safety review of Magnevist, MultiHance, Omniscan, and Optimark, as well as other gadolinium contrast injections for MRIs, CT scans, and other radiology procedures.

In May 2018 Health Canada issued this document, “Summary Safety Review – Gadolinium based contrast agents – Assessing the risk of gadolinium build-up in the brain and potential brain and nervous system (neurological) side effects”. Therein, this drug safety regulatory agency for Canada announced the results of its second safety review of Magnevist, MultiHance, Omniscan, and Optimark, as well as other radiology contrast agents containing gadolinium.

From the Safety Review Findings part of that May 2018 Health Canada document we get these three points:

  1. This safety review looked at published and unpublished studies (57 in humans and 12 in animals) and 7 international case reports of gadolinium build-up in the brain linked to the use of GBCAs. The human studies and case reports found evidence of gadolinium build-up in the brain, in most cases this occurred many months after the use of GBCAs. Similar findings were seen in the animal studies.
  2. Evidence from these studies suggests that the risk of gadolinium build-up in the brain is higher with repeated use of GBCAs and with linear GBCAs. However, gadolinium build-ups were seen with both types of GBCAs.
  3. Factors that may increase the risk of gadolinium build-up in the brain following the use of GBCAs are not yet completely understood. However, patients who may need repeated GBCA use and vulnerable populations (e.g. children, pregnant women) may be more at risk of gadolinium build-up in the brain.

Our law firm is investigating possible products liability lawsuits against the pharmaceutical companies responsible for the linear gadolinium-based contrast agents, or contrast dyes, which are shown below:

  • Magnevist — Bayer HealthCare Pharmaceuticals Inc.
  • Eovist — Bayer HealthCare Pharmaceuticals Inc.
  • MultiHance — Bracco Diagnostics Inc.
  • Omniscan — GE Healthcare
  • OptiMARK — Liebel-Flarsheim Company LLC
  • Ablavar — Lantheus Medical Imaging, Inc.

If we can be of assistance to you or a loved one as regards a possible gadolinium contrast agents case, please do not hesitate to contact us.

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Gadolinium Retention Higher For Linear Agents Than Macrocyclic Agents

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Gadolinium Based Contrast Agents (GBCAs) are substances that are injected into patients during a Magnetic Resonance Imaging (MRI) or Magnetic Resonance Angiography (MRA) in order to produce clearer radiology images. However, as explained below, unfortunately some patients have experienced gadolinium side effects after these contrast agents were used for MRIs and MRAs.

More fundamentally, there are two types of gadolinium based contrast agents (GBCAs): linear and macrocyclic. Generally, the macrocyclic GBCAs are regarded as “safer” than the linear GBCAs, as the structure of the macrocyclic gadolinium agents makes it more difficult for the gadolinium to break away from its bonding agent. When this happens, there can be gadolinium retention and related harmful medical conditions.

Furthermore, this gadolinium retention situation can lead to various serious medical problems which have been given the general diagnosis label of Gadolinium Deposition Disease (GDD). Essentially, this GDD diagnosis indicates there is some medical condition associated with gadolinium toxicity which is present in the patient. Alternatively, this gadolinium retention situation is sometimes called Gadolinium Storage Condition.

In May 2018 the Radiology medical journal published an experimental study article which examined the difference between linear gadolinium contrast agents and macrocyclic agents with respect to gadolinium retention. The study findings support the contention that following the injection of linear gadolinium based contrast agents there is more gadolinium retention.

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MRI Contrast Agents: Gadolinium Retention Warnings Added To Drug Label

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The gadolinium contrast agents safety warnings announced by the FDA in December 2017 started to be seen on new drug labels approved in the spring of 2018.

It is important to understand that symptoms of gadolinium-related medical conditions can first appear anywhere from just a few hours until several weeks after the MRI or MRA procedure when a gadolinium-based contrast agent (GBCA) dye was administered by injection.

Some of the more common symptoms reported by patients are:

  • Severe pain in the bones, joints, arms, and legs
  • Sensation of sharp pins and needles, cutting, or burning
  • Thickening of soft-tissue, tendons, and ligaments
  • Tightness in the hands and feet
  • Nausea / vomiting
  • Cognitive impairment
  • Clouded mentation (“brain fog”)
  • Persistent headache

Our law firm is investigating possible products liability lawsuits against the pharmaceutical companies responsible for the gadolinium-based contrast agents, or contrast dyes, which might cause any of these symptoms.

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Gadolinium Deposition Disease Explained: How It Is Diagnosed, And More

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A person who received an injection of a gadolinium-based contrast agent (GBCA) may develop some medical conditions following their MRI or MRA procedure which could be symptoms of gadolinium deposition disease.

These various gadolinium-related symptoms include:

  • Persistent headache;
  • “Brain fog”;
  • Skin that appears spongy or rubbery, which is actually subcutaneous soft tissue thickening;
  • Tendons and ligaments which are painful and have a thickened appearance;
  • Bone and joint pain;
  • Tightness in hands and feet; and,
  • Pain described as burning, cutting, or “pins and needles” in the arms or legs and the torso.

If a person starts experiencing one or more of these symptoms within two months after a gadolinium contrast agent was used, they may have developed gadolinium deposition disease (gadolinium toxicity or poisoning) due to the GBCA injection they received for their MRI.

Where gadolinium deposition disease is suspected by a patient or a doctor, testing for retained gadolinium is the next step in determining whether the symptoms are, in fact, due to the gadolinium contrast agent used for the MRI or MRA. There are two types of tests which might be used:

  1. 24-hour urine gadolinium test; and
  2. Heavy metal testing using blood, hair or nail samples, or urine.

If one or both of these tests are “positive” for gadolinium, the symptoms experienced by that person may be diagnosed by a doctor as gadolinium deposition disease.

Our law firm is investigating possible products liability lawsuits against the pharmaceutical companies responsible for the gadolinium-based contrast agents, or contrast dyes, which might cause any of the several symptoms that fall under the gadolinium deposition disease diagnosis label.

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Law Offices of Thomas J. Lamb, P.A.
1908 Eastwood Road, Suite 225
Wilmington, North Carolina 28403
910-256-2971 | 800-426-9535
TJL@LambLawOffice.com