Gadolinium‐Induced Nephrogenic Systemic Fibrosis Is Associated with Insoluble Gd Deposits in Tissues: <i>In Vivo</i> Transmetallation Confirmed by Microanalysis

Abstract

The demonstration of insoluble tissue deposits of Gd with co-associated elements clearly confirms in vivo transmetallation and dissociation of soluble Gd-chelates. Toxic Gd(3+) may trigger fibrosis under permissive conditions, e.g., in renal insufficiency. Pathologists and clinicians need to be aware of this serious but preventable disease.