Invest Radiol 2021 Jan 15. Epub 2021 Jan 15.
From the Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA CytoAnalytics, Denver, CO Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA Department of Radiology, Hospital Garcia de Orta, Almada, Portugal Richard Semelka Consulting, PLLC, Chapel Hill, NC.
Objectives: The aim of this study was to determine the following in patients who have undergone magnetic resonance imaging with gadolinium-based contrast agents (GBCAs) and meet the proposed diagnostic criteria for gadolinium deposition disease (GDD): (1) the effectiveness of chelation therapy (CT) with intravenous Ca-diethylenetriaminepentaacetic acid in removing retained gadolinium (Gd) and factors affecting the amount removed; (2) the frequency of CT-induced Flare, that is, GDD diagnostic symptom worsening, and factors affecting Flare intensity; (3) whether, as reported in a separate cohort, GDD patients' serum cytokine levels differ significantly from those in healthy normal controls and change significantly in response to CT; and (4) whether urine Gd, Flare reaction, and serum cytokine findings in GDD patients are mimicked in non-ill patients described as having gadolinium storage condition (GSC).
Materials And Methods: Twenty-one GDD subjects and 3 GSC subjects underwent CT. Patients provided pre-CT and post-CT 24-hour urine samples for Gd content determination along with pre-CT and 24-hour post-CT serum samples for cytokine analysis. Read More