Anaphylactoid reaction to iopamiro (after pretreatment)

A patient is described with a past history of an anaphylactoid reaction to contrast media who reacted to nonionic contrast media after pretreatment with antihistamines and steroids. The available options to reduce the incidence of reactions include use of non-ionic contrast which has a reported lower frequency than ionic contrast or some form of pretreatment. Various forms of pretreatment have been described and in the majority steroids and antihistamines are used. We describe a patient who reacted to nonionic contrast after a pretreatment regime.