Immediate hypersensitivity reaction to gadolinium-based MR contrast media

Area of Science:

• Radiology and Imaging
• Pharmacovigilance
• Clinical Allergy

Background:

• Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance (MR) imaging.
• Immediate hypersensitivity reactions (IHRs) to GBCAs are a known complication.
• Understanding the incidence and risk factors of IHRs is crucial for patient safety.

Purpose of the Study:

• To determine the incidence of immediate hypersensitivity reactions (IHRs) to gadolinium-based MR contrast agents.
• To identify risk factors associated with IHRs.
• To assess the recurrence rate of IHRs upon re-exposure.

Main Methods:

• Retrospective study of electronic medical records from August 2004 to July 2010.
• Analysis of 141,623 GBCA doses in 84,367 patients.
• Statistical analysis including chi-squared tests, t-tests, ANOVA, and logistic regression.

Main Results:

• The overall incidence of IHRs was 0.079% (112 reactions in 102 patients).
• Gadobenate dimeglumine had the highest IHR rate (0.22%), while gadodiamide had the lowest (0.013%).
• Risk factors included female sex (OR=1.687), allergies/asthma (OR=2.829), and prior IHRs (30% recurrence). Urticaria was the most common symptom (91.1%).

Conclusions:

• The incidence of IHRs to GBCAs is low but significant.
• Female patients and those with a history of allergies or asthma are at increased risk.
• A substantial recurrence rate of 30% exists for patients with prior IHRs, necessitating careful consideration for re-exposure.