ReportGadolinium is detectable within the tissue of patients with nephrogenic systemic fibrosis
Section snippets
Methods
Thirteen blocks of paraffin-embedded tissue from 7 patients with a clinical and histopathologic diagnosis of NSF were obtained from the NSF Registry. Included with this submission was an additional paraffin-embedded block containing tissue from routine dermatopathology case processed and stored at the same dermatopathology facility. Participants in Colorado were blinded as to which blocks of tissue represented cases of NSF and which blocks represented negative controls. Positive
Control specimens
Large amounts of gadolinium were detected on carbon planchettes coated directly with contrast agent. This provided reassurance that the EDS apparatus could reliably detect gadolinium. Waste tissue doped with gadolinium-containing contrast also contained large amounts of detectable gadolinium upon examination with EDS, indicating that the material survived tissue processing. The needle track from the doping process was readily identified at low magnification, with a decreasing gradient of
Discussion
The cause of NSF has never been convincingly established.8 Admittedly, our study does not establish causation with respect to gadolinium-containing contrast agents used in MRI. Yet this interesting and novel observation of gadolinium particles within the tissue of NSF patients corroborates recent observations of an epidemiologic association between exposure to gadolinium-based contrast agents and development of NSF.9, 10
Accumulation of gadolinium within body tissue from gadolinium-containing
Conclusion
In conclusion, our study provides spectroscopic and histologic evidence to support recent epidemiologic associations between gadolinium-containing contrast and the development of NSF. This pilot investigation documented gadolinium deposition in 4 of 13 specimens from 7 patients with NSF. No gadolinium was detected in a single negative control from a patient without NSF. Correlation is not equivalent to causation, but the presence of gadolinium may implicate certain contrast agents, or even the
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Funding sources: None.
Conflicts of interest: None identified.
Reprints not available from the authors.