Gadolinium Lawyer

Reporting in the October issue of the American Journal of Dermatopathology, Researchers at Wake Forest University, Baptist Medical Center suggest a possible explanation for why some patients on kidney dialysis who are injected with a “contrast agent” during a magnetic resonance imaging (MRI) develop nephrogenic systemic fibrosis (NSF). a rare tightening and swelling of the skin and other organs, including the lungs and heart

The researchers tested the hypothesis that TG2, an enzyme known as transglutaminase-2, may be involved in the response. The enzyme is found throughout the body and is involved in blood clotting and wound healing. They hypothesized that gadolinium may activate the enzyme and cause NSF.  The group obtained skin biopsies from five people with NSF and three healthy people. All NSF patients had renal failure and had previously had imaging procedures using gadolinium. The researchers tested for the presence of TG2 in the skin samples. “Compared to the healthy subjects, there was a marked increase in TG2 in the subjects with NSF,” said Sane. “This suggests that activation of TG2 can produce the syndrome. TG2 is expressed in virtually all tissues and may explain why the fibrosis can occur in the heart and lungs, as well as the skin.” 

“Our research is a pilot study, but we believe the results warrant further research into the use of TG-2 inhibitors in the treatment and prevention of NSF,” said Gil Yosipovitch, M.D., co-senior researcher, and a dermatologist. “Solving this puzzle might allow dialysis patients to take full advantage of the diagnostic capabilities of MRI.”

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