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Complement activation following intravenous contrast material administration.

P Lieberman, R L Siegle

    The Journal of Allergy and Clinical Immunology
    |July 1, 1979
    PubMed
    Summary
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    Iodinated contrast material (ICM) injection activates the complement system, a key part of the immune response. This complement activation can occur even without observable patient reactions.

    Area of Science:

    • Immunology
    • Radiology
    • Pharmacology

    Background:

    • Untoward reactions to iodinated contrast material (ICM) are a significant clinical issue.
    • The role of the complement system in these reactions requires further investigation.

    Purpose of the Study:

    • To evaluate the possibility of complement activation during ICM-induced reactions.
    • To compare complement component levels in patients with and without ICM reactions.

    Main Methods:

    • Assayed complement components (CH50, C3, C4, C5) in patients experiencing ICM reactions (reactor group).
    • Collected blood samples during reactions and two weeks later for baseline comparison.
    • Analyzed complement levels in a control group before and 20 minutes after non-reactive ICM injections.

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    Main Results:

    • Consistent decreases in total hemolytic complement (CH50), C3, C4, and C5 were observed in both groups.
    • Statistically significant falls in CH50 were noted specifically in the reactor group.
    • Complement activation was detected following ICM injection, irrespective of clinical reactions.

    Conclusions:

    • Complement activation is a consequence of iodinated contrast material injection.
    • This activation can be asymptomatic.
    • Pre-existing low complement levels or falls in CH50 before ICM infusion may correlate with anaphylactoid symptoms.