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Complement and contrast material reactors.

E C Lasser, J H Lang, S G Lyon

    The Journal of Allergy and Clinical Immunology
    |August 1, 1979
    PubMed
    Summary
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    Systemic reactions to intravascular contrast media are linked to lower levels of serum C1-esterase inhibitor (C1 INH) and total hemolytic complement (CH50). This suggests contrast media may trigger complement activation, leading to anaphylactoid reactions in patients with reduced inhibitor levels.

    Area of Science:

    • Immunology
    • Pharmacology
    • Clinical Medicine

    Background:

    • Intravascular contrast media administration can elicit systemic reactions.
    • The underlying mechanisms of these anaphylactoid reactions are not fully understood.
    • Complement system activation is implicated in hypersensitivity reactions.

    Purpose of the Study:

    • To investigate the role of serum C1-esterase inhibitor (C1 INH) and total hemolytic complement (CH50) in patients experiencing systemic reactions to intravascular contrast media.
    • To determine if pre-existing levels of C1 INH and CH50 correlate with contrast media-induced anaphylactoid reactions.

    Main Methods:

    • Comparison of mean serum C1 INH and CH50 levels between patients with and without systemic reactions to contrast media.
    • Analysis of baseline serum samples and samples post-contrast media injection.

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  • Statistical analysis to determine significant differences (p < 0.05).

    • Main Results:

    • Significantly different mean values for C1 INH and CH50 were observed between reactors and non-reactors (p < 0.05).
    • Lower concentrations of C1 INH and CH50 were found in patients who experienced reactions, evident even in baseline samples.
    • These findings were consistent in samples taken after contrast media injection.

    Conclusions:

    • Anaphylactoid reactions to intravascular contrast media may be conditioned by prior complement consumption.
    • Contrast media-induced activation of complement and other systems, in the context of reduced inhibitor levels, likely contributes to these reactions.
    • Measuring C1 INH and CH50 may help identify patients at higher risk for contrast media hypersensitivity.