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Complement activation by iodinated contrast media
Insights
Iodinated contrast media (ICM) activate complement pathways in children with congenital heart disease, but this activation does not cause adverse reactions. Complement system components like CH50 and C3 showed decreased activity post-infusion.
Area of Science:
- Cardiology
- Immunology
- Radiology
Background:
- Congenital heart disease (CHD) necessitates diagnostic procedures like angiocardiography.
- Iodinated contrast media (ICM) are frequently used in these procedures.
- Potential activation of the complement system by ICM is a concern.
Purpose of the Study:
- To investigate the activation of the complement system by ICM in children with CHD.
- To determine if complement activation correlates with adverse reactions to ICM.
Main Methods:
- Studied 25 children with CHD undergoing angiocardiography with 76% Urographin.
- Measured complement components (CH50, C1q, C3, C4, C3 activator) before and at multiple time points after ICM infusion.
Main Results:
- Significant decreases in total hemolytic activity (CH50), C3, C3 activator, C1q, and C4 were observed post-infusion.
- Complement activation occurred via both classic and alternative pathways.
- No adverse reactions were reported in any of the patients.
Conclusions:
- ICM activates both classic and alternative complement pathways in children with CHD.
- Complement activation by ICM in this context does not appear to cause adverse reactions.
Abstract:
Activation of the complement system by iodinated contrast medium (ICM) infusion was studied in 25 children with congenital heart disease who received 76% Urographin during angiocardiographic studies. Total hemolytic activity (CH50), C1q, C3, C4 and C3 activator were determined before and 2, 5, 10, 15 and 20 minutes after Urographin infusion. Results showed that CH50 decreased in 16 patients (64%), C3 in 12 patients (48%), C3 activator in 12 patients (48%), C1q in 11 patients (44%) and C4 in 11 patients (44%). No side effect was encountered in all patients. It is therefore concluded that both the classic and alternative complement pathways could be activated by ICM and no causal relationship could be found between the presence of complement activation and the occurrence of adverse reactions to ICM infusion.