Disclosures: Wayne Kuang: No financial relationships or conflicts of interest

Case Diagnosis: 47-year-old male developed Gadolinium Deposition Disease (GDD) after use of gadolinium based contrast agents (GBCA) with magnetic resonance imaging (MRI).

Case Description: A 47-year-old man with no significant past medical history prior to initial symptoms first experienced symptoms in 2010, 3 months after pelvic MRI with GBCA was used to diagnose uncomplicated spermatocele. Patient has had 4 additional MRI with GBCA. After each time, symptoms further developed and worsened. He was diagnosed with GDD in 2018 after MRI of the brain showed enhancement within the globus pallidus and dentate nuclei and all other diagnoses were ruled out. Patient chief complaints include constant burning sensations in multiple parts of his body, numbness in hands and feet, nocturnal myoclonus, livedo reticularis, and fatigue.

Setting: Outpatient pain management clinicAssessment/

Results: The appearance of patient’s symptoms coincide with usage of GBCA, particularly linear-GBCA, though macrocyclic GBCA usage may have also contributed. Imaging of the brain shows enhancement in the globus pallidus and the dentate due to gadolinium deposition. This disease can potentially be further confirmed through comprehensive urine element profile and ferritin lab reports.

Discussion: GDD, first described in 2016, is a rare occurrence when people with normal renal function develop chronic symptoms after undergoing MRI with GBCA. This is the first case report documenting a patient’s experience over the past decade and the symptoms taking place after receiving multiple MRIs with GBCA. Literature indicates that specifically linear-GBCA are more likely to have bodily depositions, and thus more likely to have signs of gadolinium toxicity. Patient’s symptoms indicate chronic gadolinium toxicity, exacerbated by multiple exposures to linear-GBCA.

Conclusion: Increasing research and reports indicate potential harm from specifically linear-GBCA. More research is necessary to understand the pathophysiology and the potential impact; however, the FDA should consider following the footsteps of Europe and Japan to ban usage of certain linear-GBCA.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/long-term-effects-of-gadolinium-deposition-disease-a-case-report/