[Severe thrombocytopenia induced by radiographic non-ionic contrast medium]

Area of Science:

• Radiology
• Hematology
• Pharmacology

Background:

• Iodinated contrast media are widely used in medical imaging.
• Adverse reactions to contrast media are typically hypersensitivity or nephrotoxicity.
• Thrombocytopenia is a rare but serious potential adverse effect.

Observation:

• A 70-year-old male developed severe thrombocytopenia and purpura 3 hours after intravenous iodinated contrast media (iopamidol) administration for a brain CT scan.
• Initial platelet count was normal; no prior contrast allergy or exposure.
• Platelet transfusion and corticosteroids were administered, with gradual recovery over 2 days.

Findings:

• In vitro testing with iopamidol and the patient's blood demonstrated platelet aggregation and a decrease in platelet count.
• This suggested that the patient's thrombocytopenia was directly induced by the iodinated contrast medium.
• The mechanism involved contrast medium-induced platelet aggregation.

Implications:

• This case highlights a rare but potentially life-threatening adverse reaction to iodinated contrast media.
• Clinicians should consider contrast-induced thrombocytopenia in patients presenting with unexplained thrombocytopenia post-imaging.
• Prompt recognition and management are crucial for patient outcomes.