J Korean Soc Radiol.  2017 Feb;76(2):148-151. 10.3348/jksr.2017.76.2.148.

A Case Report on a Severe Anaphylaxis Reaction to Gadolinium-Based MR Contrast Media

• Park J
• Kim TH
• Park CM
• Yoon SH
• Lee W
• Kang HR
• Choi YH

• KMID: 2367863
• DOI: http://doi.org/10.3348/jksr.2017.76.2.148

Abstract

Acute hypersensitivity reactions to gadolinium-based magnetic resonance (MR) contrast media have been shown to have a much lower incidence and they are generally milder in terms of severity than acute adverse reactions associated with the use of iodinated contrast media for computed tomography scans. However, even though it is rare, a severe hypersensitivity reaction to MR contrast media can occur. Here we present the case of a 66-year-old woman who experienced a severe hypersensitivity reaction after administration of gadolinium-based contrast media without a previous history of allergies.

MeSH Terms

Aged
Anaphylaxis*
Contrast Media*
Female
Humans
Hypersensitivity
Incidence
Magnetic Resonance Imaging
Contrast Media

Figure

• 

  Fig. 1 Timeline of the patient's clinical course including clinical events, medication and vital signs. bpm = beats per minute, Chlor = chlorpheniramine, Epi = epinephrine, ER = emergency room, HR = heart rate, NE = norepinephrine, PD = prednisolone, SBP = systolic blood pressure, Sz = seizure

Reference

1. Dillman JR, Ellis JH, Cohan RH, Strouse PJ, Jan SC. Frequency and severity of acute allergic-like reactions to gadolinium-containing i.v. contrast media in children and adults. AJR Am J Roentgenol. 2007; 189:1533–1538.

2. Prince MR, Zhang H, Zou Z, Staron RB, Brill PW. Incidence of immediate gadolinium contrast media reactions. AJR Am J Roentgenol. 2011; 196:W138–W143.

3. Hunt CH, Hartman RP, Hesley GK. Frequency and severity of adverse effects of iodinated and gadolinium contrast materials: retrospective review of 456,930 doses. AJR Am J Roentgenol. 2009; 193:1124–1127.

4. Jung JW, Kang HR, Kim MH, Lee W, Min KU, Han MH, et al. Immediate hypersensitivity reaction to gadolinium-based MR contrast media. Radiology. 2012; 264:414–422.

5. Kim MH, Hong JH, Lee YS, Cha KS, Lee YC, Chang SI, et al. Clinical experience of adverse drug reaction in gadolinium-DTPA enhancement of MRI. J Korean Radiol Soc. 1992; 28:303–306.

6. Nelson KL, Gifford LM, Lauber-Huber C, Gross CA, Lasser TA. Clinical safety of gadopentetate dimeglumine. Radiology. 1995; 196:439–443.

7. Niendorf HP, Dinger JC, Haustein J, Cornelius I, Alhassan A, Clauss W. Tolerance data of Gd-DTPA: a review. Eur J Radiol. 1991; 13:15–20.

8. Brockow K, Christiansen C, Kanny G, Clément O, Barbaud A, Bircher A, et al. Management of hypersensitivity reactions to iodinated contrast media. Allergy. 2005; 60:150–158.

9. American College of Radiology. Manual on Contrast Media v10.2. Accessed July 26, 2015. Available at: http://www.acr.org/quality-safety/resources/contrast-manual.

10. European Society of Urogenital Radiology. ESUR Guidelines on Contrast Media. Accessed July 26, 2015. Available at: http://www.esur.org/guidelines/.