MRI Contrast Dye and Nephrogenic Systemic Fibrosis (NSF) Nephrogenic Fibrosing Dermotherapy (NFD)
MRI stands for Magnetic Resonance Imaging, and is a medical imaging device used to view any internal part of the body. Used for brain scanning, cardiovascular, skeletal and cancer imaging.
Nephrogenic systemic fibrosis associated with gadolinium exposure during MRI
NSF is a rare multisystemic fibrosing disorder that primarily affects the skin but may affect other organs of patients with renal (kidney) problems.
Studies provided by the American Roentgen Ray Society illustrate a risk factor associated with gadolinium based contrast dyes that are commonly used during an MRI scan. The study shows that the development of NFS takes place in patients within 2-11 weeks after gadodiamide administration. It should be noted that this condition mainly appears in people with end-stage renal (kidney) disease.
Symptoms and Diagnosis of Nephrogenic systemic fibrosis (NSF)
- Swelling of the skin
- Skin tightening
- Muscle weakness
- Skin discoloration
- Hardened patches of skin
- Reddened or darkened patches of skin
- Skin may look and feel similar to an orange peel
- Burning, itching or severe pain
MRI Contrast Dye
Contrast dye is a liquid solution that is injected into a person undergoing either an MRI or MRA scan. This dye can be injected into the blood veins, taken orally, or inserted into the rectum. The primary purpose of contract dye is to highlight and allow for better details of the MRI image. Contrast dye works by altering the magnetic properties of the tissue.
The most commonly used brands of MRI contrast dyes that contain gadolinium are ProHance, MultiHance, Omniscan, OptiMARK, and Magnevist brand.
FDA issues Black Box Warning on Gadolinium based contract dyes.
FDA notified healthcare professionals of the Agency's request for the addition of a boxed warning and new warnings about the risk of nephrogenic systemic fibrosis (NSF) to the full prescribing information for all gadolinium-based contrast agents (GBCAs). The new prescribing information FDA is requesting highlights and describes the risk for NSF following exposure to a GBCA in patients with acute or chronic severe renal insufficiency (glomerular filtration rate <30 mL/min/1.73m2) and patients with acute renal insufficiency of any severity due to the hepato-renal syndrome or in the peri-operative liver transplantation period. Healthcare professionals should avoid the use of a GBCA in these patients unless the diagnostic information is essential and not available with non-contrast enhanced magnetic resonance imaging.