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Diagnosing nephrogenic systemic fibrosis in the post‐FDA restriction era
Author(s) -
Thomson Laura K.,
Thomson Peter C.,
Kingsmore David B.,
Blessing Karen,
Daly Conal D.,
Cowper Shawn E.,
Roditi Giles H.
Publication year - 2015
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24664
Subject(s) - nephrogenic systemic fibrosis , medicine , food and drug administration , intensive care medicine , renal function , pharmacology , kidney disease
The emergence of an association between gadolinium‐based contrast agents (GBCA) and the rare condition nephrogenic systemic fibrosis (NSF) led to a warning in 2006 from the Food and Drug Administration (FDA) restricting the use of the GBCAs to patients with an estimated glomerular filtration rate of >30 mL/min/1.73m 2 . We discuss our experience with a post‐FDA restriction presentation of NSF and subsequent patient death in which the prolonged lead‐time of ∼5.5 years led to challenges in ensuring a secure diagnosis of NSF and establishing risk exposures. Accurate contemporary records of contrast administration and clinical factors alongside clinical and pathological expertise ensured that we were able to confidently diagnose NSF, despite the length of lead time and confounding factors. J. Magn. Reson. Imaging 2015;41:1268–1271. © 2014 Wiley Periodicals, Inc.