Brief History of NSF/NSD and Gadolinium

The Federal Drug and Food Administration issued in June of 2006 (and later with additional FDA Alerts in December 2006 and May 2007), a warning to Health Care Professionals, concerning Gadolinium Based Contrast Agents (GMCAs), used for Magnetic Resonance Imaging (MRI) and the risk of contracting Nephrogenic Systemic Fibrosis (NSF).

The first reports of patients suffering from NSF occurred in early 1996 where the Danish Health Authority began observing a number of cases of NSF. In June of 1996, the FDA after receiving 25 reported cases of NSF began to compile information on NSF from post-marketing reports.

At this time, a number of medical articles, including an article by H.L. Zhang, H. Ersoy, and M.R. Prince began to assess the general safety of GMCAs in patients with impaired renal failure.

Other authors focused on examining the casual relationship between NSF and GMCAs
Since the FDA’s initial June 2006 Warning, there have been a number of recent medical articles documenting the relationship between GMCAs and NSF.

See “Gadolinium-based contrast exposure, nephrogenic systemic fibrosis, and gadolinium detection in tissue“, Wiginton CD, Kelly B, Oto A, Jesse M, Aristimuno P, Ernst R, Chaljub G., in AM J ROENTGENOL. 2008 Apr;190(4):1060-8.

On April 27, 2007, the International Center for Nephrogenic Fibrosing Dermopathy Research (ICNFDR) at Yale, issued a report citing to a total of 236 reported cases.

On May 23, 2007, the FDA formally requested that all manufacturers of GMCAs place a Black-Box warning for contrast agents used for MRI imaging, namely that such warning should disclose that “patients with severe kidney insufficiency who receive gadolinium-based agents are at risk for developing a debilitating, and a potentially fatal disease known as nephrogenic systemic fibrosis (NSF).”