Near-cure in patients with Gadolinium deposition disease undergoing intravenous DTPA chelation

IF 3.6 Q2 TOXICOLOGY Frontiers in toxicology Pub Date : 2024-07-25 DOI:10.3389/ftox.2024.1371131
R. Semelka, M. Ramalho
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Abstract

To demonstrate and evaluate factors contributing to near-cures in patients with Gadolinium Deposition Disease (GDD) undergoing intravenous (IV) DTPA chelation.Patients who had undergone or are currently undergoing DTPA chelation for GDD were included in this report based on their medical records that showed their perceived improvement was at least 80% back to normal. A survey was developed that included factors commonly reported by patients treated in one clinic to determine if these ‘near-cured’ (pre-MRI baseline health) individuals possessed certain factors and lacked others. The anonymized survey was emailed to these individuals by the principal treating physician, the only investigator not blinded to the subjects. This report describes clinical documentation of patient status and their underlying factors in individuals treated by the primary author, and no research was performed. The survey was sent to sixteen individuals; Fourteen patients completed it (10 females; 41.1 ± 11.2 y/o).The most common factor was the administration of ≤5 lifetime doses of a Gadolinium-Based Contrast Agents (GBCA) (12/14). Unconfounded agents triggering GDD were seen in nine subjects. Most subjects (12/14) initiated chelation in the first year after the causative GBCA, and most (11/14) underwent ≤10 chelations with DTPA. Good healthcare status prior to MRI was observed in 5 subjects. The majority (11/14) described their immune status as strong. Severe physical disability prior to chelation was seen in 1.Subjects with GDD can experience near-cure with IV DTPA chelation. Factors surveyed that predict near-cure include the start of chelation in the first year, few GBCA administrations, and good health status before MRI with GBCA injection. Nonetheless, a few patients with predictors of less successful outcomes still experienced near-cure.
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接受静脉 DTPA 螯合治疗的钆沉积病患者几近痊愈
本报告的研究对象包括接受过或正在接受 DTPA 螯合治疗的钆沉积症(GDD)患者,依据是他们的医疗记录显示,他们认为自己的病情至少有 80% 已恢复正常。为了确定这些 "濒临痊愈"(MRI 前的基线健康状况)的患者是否具备某些因素而缺乏其他因素,我们制定了一项调查,其中包括在一家诊所接受治疗的患者通常报告的因素。匿名调查表由主治医师通过电子邮件发送给这些人,主治医师是唯一一位对受试者没有盲法的研究人员。本报告描述了由主要作者治疗的个人的患者状态及其潜在因素的临床记录,并未进行任何研究。最常见的因素是终生使用钆基造影剂(GBCA)的剂量≤5 次(12/14)。有 9 名受试者使用了引发 GDD 的不明药物。大多数受试者(12/14)在使用致病 GBCA 后的第一年开始接受螯合治疗,大多数受试者(11/14)接受了≤10 次 DTPA 螯合治疗。有 5 名受试者在磁共振成像前健康状况良好。大多数受试者(11/14)称其免疫状况良好。1名受试者在螯合前有严重的肢体残疾。据调查,预测接近痊愈的因素包括第一年开始螯合、GBCA用药次数少以及注射GBCA进行核磁共振成像前健康状况良好。尽管如此,仍有少数预示疗效不佳的患者濒临痊愈。
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来源期刊
CiteScore
3.80
自引率
0.00%
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0
审稿时长
13 weeks
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