Pathophysiology of Immediate Reactions to Injectable Gadolinium-based Contrast Agents

The aim of this paper was to review the classification of adverse drug reactions, highlight the known pathophysiology of immediate hypersensitivity reactions, and discuss the utility of diagnostic testing for immunologically mediated immediate reactions to gadolinium-based contrast agents (GBCAs).

Current literature on immediate reactions to GBCA was reviewed and summarized.

Adverse drug reactions to GBCA are rare, and can be attributed to physiologic, immunologic, and nonimmunologic processes. When immunologic reaction is suspected, particularly in the case of severe reactions, skin testing may be useful to confirm allergy and identify alternative agents for subsequent studies.

As GBCAs are widely used for the diagnosis and monitoring of disease, the incidence of adverse drug reactions to GBCA warrants ongoing development of approaches to diagnosis and avoidance of these adverse events.