Yonsei Med J.  2015 Jul;56(4):1155-1157. 10.3349/ymj.2015.56.4.1155.

Acute Respiratory Distress Syndrome after the Use of Gadolinium Contrast Media

• Park J
• Byun IH
• Park KH
• Lee JH
• Nam EJ
• Park JW

• KMID: 2366361
• DOI: http://doi.org/10.3349/ymj.2015.56.4.1155

Abstract

Acute respiratory distress syndrome (ARDS) is a medical emergency that threatens life. To this day, ARDS is very rarely reported by iodine contrast media, and there is no reported case of ARDS induced by gadolinium contrast media. Here, we present a case with ARDS after the use of gadobutrol (Gadovist) as a magnetic resonance imaging (MRI) contrast medium. A 26 years old female without any medical history, including allergic diseases and without current use of drugs, visited the emergency room for abdominal pain. Her abdominopelvic computed tomography with iodine contrast media showed a right ovarian cyst and possible infective colitis. Eighty-three hours later, she underwent pelvis MRI after injection of 7.5 mL (0.1 mL/kg body weight) of gadobutrol (Gadovist) to evaluate the ovarian cyst. She soon presented respiratory difficulty, edema of the lips, nausea, and vomiting, and we could hear wheezing upon auscultation. She was treated with dexamethasone, epinephrine, and norepinephrine. Her chest X-ray showed bilateral central bat-wing consolidative appearance. Managed with mechanical ventilation, she was extubated 3 days later and discharged without complications.

Keyword

Gadolinium; gadobutrol; acute respiratory distress syndrome

MeSH Terms

Adult
Animals
Contrast Media/administration & dosage/*adverse effects
Female
Gadolinium
Humans
Magnetic Resonance Imaging/*methods
*Organometallic Compounds/adverse effects
Respiratory Distress Syndrome, Adult/*chemically induced
Tomography, X-Ray Computed
Contrast Media
Gadolinium
Organometallic Compounds

Figure

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  Fig. 1 Chest X-ray features of the patient: (A) when the symptoms presented, (B) immediately after intubation, (C) before discharge from the intensive care unit.

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