Sameer M. Mazhar1, Masoud Shiehmorteza2, Michael S. Middleton2, Claude B. Sirlin2
1Department of Medicine, Division of Gastroenterology, University of California, San Diego, San Diego, CA, USA; 2Department of Radiology, University of California, San Diego, San Diego, CA, USA
Gadolinium-based contrast agents have been implicated in the pathogenesis of nephrogenic systemic fibrosis. The FDA has released a black box warning cautioning against the use of gadolinium in patients with liver disease. Our review of the literature, however, does not suggest that liver disease confers an increased risk for NSF beyond that of the underlying renal insufficiency.