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Anaphylaxis in the Radiology Suite.

Karen S Hsu Blatman1, Mario Sánchez-Borges2, Paul A Greenberger3

  • 1Section of Allergy and Immunology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH.

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Patients experiencing adverse reactions to contrast media, like urticaria, can be pretreated. This approach successfully managed a patient needing repeat coronary angiography despite a history of hypersensitivity.

Keywords:
AnaphylaxisContrast mediaDrug provocationGadolinium-based contrast medium

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Area of Science:

  • Radiology
  • Allergy and Immunology

Background:

  • Contrast media are essential for medical imaging but can cause adverse reactions.
  • Adverse reactions range from pharmacological effects to hypersensitivity.
  • Predictive methods and understanding of mechanisms for contrast media reactions are limited.

Purpose of the Study:

  • To present a case of successful pretreatment for radiocontrast media in a patient with a history of hypersensitivity.
  • To highlight management strategies in the absence of predictive tools for contrast media reactions.

Main Methods:

  • A patient with a history of urticaria following contrast media exposure was evaluated.
  • Pretreatment protocols were administered prior to a repeat coronary angiography procedure.

Main Results:

  • The patient received pretreatment with corticosteroids and an H1 antihistamine.
  • The patient tolerated the repeat coronary angiography without adverse reaction.

Conclusions:

  • Successful pretreatment can be a viable strategy for patients with a history of contrast media hypersensitivity.
  • Further research is needed to understand contrast media reaction mechanisms and develop predictive tools.