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Pediatr Radiol. 2008 May;38(5):489-96; quiz 602-3. Epub 2007 Oct 18.

Gadolinium and nephrogenic systemic fibrosis: time to tighten practice.

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1
Radiology and Physics Unit, Institute of Child Health, University College London, London, UK.

Abstract

Nephrogenic systemic fibrosis (NSF) is a relatively new entity, first described in 1997. Few cases have been reported, but the disease has high morbidity and mortality. To date it has been seen exclusively in patients with renal dysfunction. There is an emerging link with intravenous injection of gadolinium contrast agents, which has been suggested as a main triggering factor, with a lag time of days to weeks. Risk factors include the severity of renal impairment, major surgery, vascular events and other proinflammatory conditions. There is no reason to believe that children have an altered risk compared to the adult population. It is important that the paediatric radiologist acknowledges emerging information on NSF but at the same time considers the risk:benefit ratio prior to embarking on alternative investigations, as children with chronic kidney disease require high-quality diagnostic imaging.

PMID:
17943276
PMCID:
PMC2292494
DOI:
10.1007/s00247-007-0633-8
[Indexed for MEDLINE]
Free PMC Article
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