[Prospective survey on adverse effects of radiopharmaceuticals]

In France, radiopharmaceuticals have been considered as drugs since 1992. Few adverse reactions with radiopharmaceuticals were described in the literature. Some authors have reported a rate of 1 to 6 reactions per 100,000 injections. The purpose of the present study was to evaluate the prevalence of radiopharmaceutical-induced side effects. A prospective survey was performed from November 1993 to May 1995 (during 18 months) in the Department of Nuclear Medicine of the University Hospital in Toulouse. There were 14,794 injections of radiopharmaceuticals (99mTc-phytate, 99mTc-microspheres of serum albumin, 99mTc-dimercapto-succinic acid (DMSA), 99mTc-hydroxymethyldiphosphonate (HMDP), 99Tc-colloid, 99mTc, 99mTc-sestamibi, Thallium-201). Three side effects were reported: one case of necrosis at the injection site, one case of vomiting and one case of dizziness. All the cases occurred with Tc99m-pyrophosphate. According to the WHO definition, the first side effect was classified as 'serious'. The causal relationship was unlikely for the first and second case and probable for the third. The outcome of these side effects was always favorable.