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GDD: What About Very Early Chelation Treatment?

In general it is true in basically all of medicine, and everything else, early treatment is essential for good outcome - this is especially true for infection and cancers, but really for almost everything: a Stitch in Time Saves Nine. From experience I have found that early treatment for GDD can be a disaster of severe Flare because of the Intensity of the Immunologic Memory for Gd. At 1.5- 2 months post GBCA injection/ GDD onset, Flare can be out of control severe...

But what about very early treatment?

I generally do not like to talk in advance about studies I would like to do myself. But what about immediate post GBCA injection, if someone has developed GDD immediately following GBCA injection.

I have always preferred to do important studies that I am interested/able to do myself, so I don't like to discuss this before I do it, because my concept may not work, and secondarily I don't like being scooped by others for an idea I have. But maybe the topic is too important to worry about someone else taking the credit.

Is it possible that the maxim of treating early can also apply to GDD?

I think we can look at COVID for the comparator, as I have done in other matters with GDD. Vaccines take about 14 days to achieve full immunity effect. It is therefore likely that immunologic memory for Gd takes 14 days to become full strength to create severe Flare. So less than 14 days, and preferably much less, such as the same day or within days of GBCA injection.

GDD may in many cases essentially be persistent Acute Hypersensitivity Reaction (AHR), transitioning from primarily Mast cell driven (AHR) to tissue resident memory Tcell driven (GDD). Should immediate AHR/ immediate GDD be treated basically as I treat first time chelation for GDD in recent onset GDD? Should they be treated in the MR facility that administered the GBCA? This would increase the recognition that radiologists would like to engender that they are also physicians.

My answer is yes. All MR facilities must know about GDD. I no longer consider it acceptable that they don't/ I have written too many papers now in major journals on the subject for it is acceptable to tell patients the world is flat, the sun orbits around the earth, all Gd leaves the body in 24 hours, just drink water. Ignorance is no longer acceptable to me.

If radiologists want to be seen as doctors, talk to patients if they complain of severe AHR/ early GDD. They should be told to return to the MR facility and be treated as I do the first chelation for GDD, and with repeat treatments in short intervals.

What I am proposing is how actually all acute AHR should be treated when it is due to GBCA, because many of these may end up as GDD. Starting shortly after the GBCA injection in subjects experiencing severe acute reaction with our first chelation for GDD approach.

Richard Semelka, MD

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