Adult Medical Issues in Cystinosis--William Gahl, M.D.

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June 2006 (25 cases); updated December 2006• FDA has received reports of 90 patients withmoderate to end-stage kidney disease whodeveloped NSF/NFD after they had an MRI orMRA with a gadolinium-based contrast agent.• Patients with moderate to end-stage kidneydisease who receive an MRI or MRA with a•gadolinium-based contrast agent may getNSF/NFD which is debilitating and may causedeath.
FOR IMMEDIATE RELEASEMay 23, 2007FDA Requests Boxed Warning for Contrast Agents Used to ImproveMRI Images
Page 1 and 2:
Section on Human Biochemical Geneti
Page 3 and 4:
CYSTINOSIS NATURAL HISTORYAgeBirthI
Page 5 and 6: CYSTINOSIS NATURAL HISTORYPost-Tran
Page 7 and 8: 22-year old withcystinosis,myopathy
Page 9 and 10: Cystine crystalsin muscleCystine cr
Page 11 and 12: Swallowing DifficultyPooling invall
Page 13 and 14: Coronary Artery CalcificationCorona
Page 15 and 16: Cerebral atrophyin a 24-year oldman
Page 17 and 18: Gastric varixDuodenal varix
Page 19 and 20: 100 Nephropathic CystinosisAdults (
Page 21 and 22: Adult Cystinosis Patients(NIH, 1986
Page 25 and 26: NIH Intent-to-treat Analysis forOra
Page 29 and 30: 4Muscle Cystine321No Cysteamine010
Page 31 and 32: CYSTEAMINE EYEDROPSUntreated Treate
Page 33 and 34: Pre-transplant, oral cysteaminether
Page 35 and 36: Post-Transplant CystinosisComplicat
Page 37 and 38: 101 Cystinosis Patients4.54Swallowi
Page 39 and 40: 60%50%n=1040%n=3830%% OF PATIENTS W
Page 41 and 42: 100%90%n=28n=10% OF PATIENTS WITH P
Page 43 and 44: 100 Adult Cystinosis PatientsCystea
Page 45 and 46: 100 Adult Cystinosis PatientsCholes
Page 47 and 48: Effect of Oral Cysteamine onthe Lat
Page 52 and 53: Nephrogenic FibrosingDermopathy
Page 54 and 55: NFD: More than skin deep• Patholo
Page 58: Risk Mitigation Strategy• Elimina
Page 61 and 62: Transmission EMof conjunctival cell
Page 63 and 64: N=89 N=32 N=24 N=9100%90%80%70%60%5
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Adult Medical Issues in Cystinosis--William Gahl, M.D.

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