Children and GDD
I've had several requests to discuss the subject of children and GDD. I have to preface this by saying I have minimal knowledge of this, so this is one of my blogs which is highly speculative.
Surprisingly there is little contact I receive regarding children and GDD, and little in the patient activist internet and Face book sites. This leads me to believe that it is relatively rare (although not impossible, as a few parents have contacted me about their children).
How is that possible, especially when we hear in the news about children who are grossly affected with neurological deficits, delayed maturation, spasticity secondary to lead, when symptoms from lead seem so similar to gadolinium in adults. Children also get a fair number of MRI studies.
Let me diverge at first. There is a large excellent paper from Ontario Canada that has suggested that fetal loss may be increased in the setting of GBCA injection to the mother. In addition there are animal model papers describing skeletal malformations in rabbits whose mothers received GBCAs. So we know that issues occur with fetuses with gadolinium exposure.
Why not so much with children? In part this may simply mean that children cannot express their symptoms so well, so it is possible for example, that brain fog from GDD may be misinterpreted as something like ADHD. But teenagers should be able to express themselves well - however teenagers rarely get MRIs. May be we don't see it in children because we don't know how to interpret the symptoms, or they simply are not getting MRIs sufficiently often (teenagers) that patterns of this disease are recognized in them.
I lean towards the possibility that it may largely reflect the maturation of the immune system. Most autoimmune disease develop in adulthood, and not childhood, and GDD is in the family of these disorders that can be thought of as selective immune system increased responsiveness. It seems as we age the immune system has a greater tendency to go awry when encountering novel antigens. In a related fashion, it has been recognized for decades that when children are exposed to antigens for the first time they often develop IgG antibodies, whereas first time exposure in adults may result more often with an IgE antibody development, which are the mediators of allergies. This may have a lot to do with it. In fact a more full description of GDD takes this somewhat into account - it really represents a: Severe Persistent Hypersensitivity Reaction with Recruitment of Chronic Immune Cells.
Treatment of children should follow treatment of adults, but in appropriately lower dose for DTPA.