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A case of gadobenate dimeglumine-induced anaphylactic shock: a case report
Jiwei Huang1, Zhuying Liu1, Caiyun Jiang1
1Department of Pharmacy, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Abstract:
A 70-year-old man was admitted to our hospital due to "liver cirrhosis; grade 3 hypertension; pulmonary infection". On May 27, 2019, during upper abdomen plain and enhanced magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP), the patient experienced anaphylactic shock, manifested as sudden unconsciousness and lack of response, after intravenous administration of gadobenate dimeglumine (Multihance®). Gadobenate dimeglumine is a paramagnetic contrast used during diagnostic MRI. It has hepatobiliary specificity with very good imaging performance. A small amount is absorbed by normal liver cells after intravenous injection and excreted via the bile ducts while maintaining the chemical structure of gadobenate dimeglumine. It allows the visualization of local angiogenesis and perfusion, which reflect the hepatic blood supply and recent liver function, thereby providing a reference for clinical diagnosis. Gadobenate dimeglumine intravenous injection may cause adverse reactions such as nausea, dizziness, and anaphylactic shock. Anaphylactic shock is a known serious adverse reaction of gadobenate dimeglumine injection. In this paper, we report a case of gadobenate dimeglumine-induced anaphylactic shock based on the temporal relationship between the onset of symptoms and the injection. The patient received chest compressions and balloon-assisted ventilation in addition to rehydration and volume expansion and vasoactive drugs to maintain blood pressure, etc. The patient died despite treatments. In the clinical, physicians, nurses, and clinical pharmacists should closely monitor patients and promptly discontinue drug administration and provide symptomatic care in case of adverse reactions.
Insights
A patient experienced fatal anaphylactic shock after receiving gadobenate dimeglumine contrast during an MRI scan. This case highlights the serious risks associated with this diagnostic agent.
Area of Science:
- Radiology
- Pharmacology
- Medical Imaging
Background:
- Gadobenate dimeglumine is an MRI contrast agent with hepatobiliary specificity, used for liver imaging.
- It aids in visualizing angiogenesis and perfusion, reflecting hepatic blood supply and function.
Observation:
- A 70-year-old male patient with pre-existing conditions developed sudden unconsciousness and unresponsiveness post-intravenous gadobenate dimeglumine administration.
- The event occurred during magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP) of the upper abdomen.
Findings:
- The patient suffered anaphylactic shock, a known serious adverse reaction to gadobenate dimeglumine.
- Despite immediate medical interventions including chest compressions and vasoactive drugs, the patient unfortunately died.
Implications:
- This case underscores the critical importance of vigilant patient monitoring during and after gadobenate dimeglumine administration.
- Healthcare professionals must be prepared to promptly manage severe adverse reactions like anaphylactic shock.
- The incident highlights the need for continued awareness of gadobenate dimeglumine's potential risks in clinical practice.
