Adverse Reactions to Contrast Agents Scope of Problem

Activation of Complement by Radiographic Contrast Media: Generation of Chemotactic and Anaphylatoxin Activities

“…Mild reactions like flushing, headache or nausea occur in approximately 3-8°/o of all patients. The incidence of severe reac tions like convulsions, asthma, cardiac ar rest or hypotensive shock is 1 in 2,000-14,000 and the incidence of deaths is 1 in 10,000-40,000 [Klumair, 1968;Ansell, 1970;Witten, 1975],…”

“…Since only a few patients have been reported to possess antibodies against contrast media [Kleinknecht et al, 1974;Bauer and Deutsch, 1975;Brasch and Caldwell, 1976] specific antibodies may play a role only in some adverse reactions. It has been reported that contrast media bind to serum proteins [Rosenbaum and Reich, 1966;Lang and Lasser, 1967], activate or inhibit various enzymes [Lasser and Lang, 1966;Lasser, 1968], induce histamine re lease [Ansell, 1970;Lasser et al, 1974] and increase vascular permeability [Hoppe, 1959;Harrington and Wiedeman, 1965]. None of these effects, however, could be linked conclusively with adverse reactions although histamine may play a substantial part.…”

99mTc-PI as safe and easy scintigraphy after hepatectomy.

“…Now, we consider that this technique is safer than either intravenous or percutaneous cholangiography (Ansell 1970 Okamoto and Kyo 1978). In our field, the scintigram obtained shortly after the segmental hepatectomy is helpful in assessing the correlation between the liver scintigram and the segmental anatomy of the liver.…”

Prevention of Anaphylactoid Reactions after Radiographic Contrast Media Infusion by Combined Histamine H₁- and H₂-Receptor Antagonists: Results of a Prospective Controlled Trial

“…The infusion of ionic radiographic contrast media (RCM) is connected with a certain risk of adverse reactions which occur at a frequency of 5-15% [2,5,26,27,31]. Lethal reactions are estimated to occur with a frequency of 1:10,000-1:40,000 [26,31].…”

“…There is little evidence for immunological reac tions [2,13,32] playing a role, but abundant data exist on the pseudo-allergic [8] nature of the adverse effects of RCM. Among nonimmunologic reactions invoked in eliciting anaphylactoid reactions after RCM infu sion are direct activation of the complement system [3,11,33], interaction with the coagulation and/or kallikrein-kinin system [14,29,32], direct release of vasoactive mediators (as histamine or serotonin) [12,25,30,32] or direct action on the central nervous sys tem [10], Due to the lack of exact knowledge about the pa thogenesis there is little reliable information about possible prophylaxis of these reactions.…”