Toxicity of gadolinium by contrast in imaging tests

Authors

DOI:

https://doi.org/10.33448/rsd-v11i15.37351

Keywords:

Gadolinium; Contrast media; Nuclear Magnetic Resonance; Nephrogenic systemic fibrosis.

Abstract

Objective: the purpose of this article is to describe the properties and utilities of Gadolinium (Gd), emphasizing its toxicity as a means of contrast in Nuclear Magnetic Resonance (NMR) exams. This research is based on describing the main adverse reactions, indications, contraindications and toxicity by the use of GBCAs, a drug commonly used as a non-ionizing contrast. Methodology: a literature review was carried out, where information was acquired in scientific articles from renowned sites such as Scientific Eletronic Library Online (SciELO) and US national Library of Medicine (PubMed). Results: Gd is a metal used in various ways for various purposes, and one of them is in NMR exams as a means of contrast. However, it can provide health risks for patients who have previous diseases, such as chronic kidneys, or those who have sensitivities or allergies, and can cause major or minor acute reactions, ranging from hives, headaches and vomiting, to anaphylactic shock and laryngospasm. However, one of the complications that have been studied with amplitude is the pathology called Nephrogenic Systemic Fibrosis (NSF). There are recently studies in which risks have been reported even in patients with renal functions within normality. Conclusion of the study: clarification of the guidelines and important information for the patient who performs the contrasted  NMR exam, and also, leave as a warning to health professionals on a topic not much addressed, but of high dangerousness.

References

Brecci, L. & Freitas, T. (2019). Efeitos nefrotóxicos do contraste à base de gadolínio. Universidade Metodista de São Paulo: XXI Congresso Metodista de Iniciação e Produção Científica.

Caldana, P., Bezerra, A., D’ippolito, G. & Szejnfeld, J. (2006). Estudo da circulação hepatomesentérica pela angiografia por ressonância magnética com gadolínio: comparação entre doses simples e dupla no estudo de pacientes esquistossomóticos. Radiologia Brasileira. 3(4): 251-243.

Darrah, T., Prutsman, J., Poreda, R., Campbell, M., Hauschka, P. & Hannigan, R. (2009). Incorporation of excess gadolinium into human bone from medical contrast agents.Oxford: Mettalomics. 1(6): 488-479.

Greenwood, N. & Earnshaw, A. (2005). Chemistry of the Elements. U.K.: Elsevier. (2nd ed.) 1059 p.

Grobner, T. (2006). Gadolinium - a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis. Oxford: NDT. 21(4): 1108-1104.

Hoffmann, R. & Garbugio, B. (2020). Meios de contraste: Fibrose Sistêmica Nefrogênica e Depósito de Gadolínio. São Paulo-SP: SPR.

Junior, J., Santos, A., Koenigkam, M., Nogueira, M. & Muglia, V. (2008). Complicações do uso intravenoso de agentes de contraste à base de gadolínio para ressonância magnética. Ribeirão Preto-SP: SciELO.

Kanda, T., Ishii, K., Kawaguchi, H., Kitajima, K. & Takenaka, D. (2013). High Signal Intensity in the Dentate Nucleus and Globus Pallidus on Unenhanced T1-weighted MR Images: Relationship with Increasing Cumulative Dose of a Gadolinium-based Contrast Material. Japão: RSNA. 270(3): 841-834.

Larson, K., Gagnon, A. & Darling, M. (2015). Nephrogenic Systemic Fibrosis Manifesting a Decade After Exposure to Gadolinium. Charlottesville: JAMA Dermatology. 151(10): 1120-1117.

Lattanzio, S. (2021). Toxicity associated with gadolinium-based contrast-enhanced examinations. Italy: AIMS Press. (2nd ed., vol. 8) 198-220.

Leon, L., Martins, A., Pinho, M., Rofsky, N. & Sherry, A. (2015). Basic MR relaxation mechanisms and contrast agent design. Texas: JMRI. 42(3): 565-545.

Meireles, X., Kreimer, S., Marchiori, A., Galon, Z. & Scanavacca, R. (2012). Cinecoronariografia com Gadolínio em Pacientes com Alergia Grave ao Contraste Iodado. São Paulo-SP: Revista Brasileira de Cardiologia Invasiva. 20(3): 32932.

Meloni, M., Barton, S., Xu, L., Kaski, J., Song, W. & He, T. (2017). Contrast agents for cardiovascular magnetic resonance imaging: an overview. JMCB. 21(1): 4118-3939.

Mundim, J., Lorena, S., Abensur, H., Elias, R., Moysés, R., Castro, M., et al. (2009). Fibrose Sistêmica Nefrogênica: uma Complicação Grave do Uso do Gadolínio em Pacientes com Insuficiência Renal. SciELO. 55(2): 220-5.

Pereira, L. (2012). Efeito protetor da N-Acetilcisteína sobre a nefrotoxicidade de meios de contraste baseados no gadolínio em modelo experimental de doença renal crônica. São Paulo-SP: Digital Library USP.

Poralla, F. & Dutra, B. (2020). Meios de Contraste à Base de Gadolínio. São Paulo-SP: SPR.

Ramalho, J., Castillo, M., Alobaidy, M., Nunes, R., Ramalho, M., Dale, B., et al. (2015). High Signal Intensity in Globus Pallidus and Dentate Nucleus on Unenhanced T1-weighted MR Images: Evaluation of Two Linear Gadolinium-based Contrast Agents. Carolina do Norte: RSNA. 276(3): 844-836.

Ramalho, J., Semelka, R., Ramalho, M., Nunes, R., Alobaidy, M. & Castillo, M. (2016). Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update. AJNR. 37(7): 1198-1192.

Santos, M. (2013). Contaminantes metálicos em contrastes a base de quelatos de gadolínio e reações de transmetalação. Santa Maria-RS: Universidade Federal de Santa Maria Centro de Ciências Naturais e Exatas Programa de Pós-Graduação em Química.

Souza, A., Carvalho, K., Edwin, S. & Carvalho, I. (2012). Nephrogenic systemic fibrosis: concepts and perspectives. SciELO. 87(4).

Published

19/11/2022

How to Cite

SILVA, G. R. da; FAZENDA, J. M. Toxicity of gadolinium by contrast in imaging tests. Research, Society and Development, [S. l.], v. 11, n. 15, p. e276111537351, 2022. DOI: 10.33448/rsd-v11i15.37351. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/37351. Acesso em: 26 dec. 2024.

Issue

Section

Health Sciences