Case report of a patient who survived after cardiac arrest and cardiogenic shock by anaphylactic reaction to gadolinium during magnetic resonance imaging

Biagioni, Emanuela; Coloretti, Irene; Disalvo, Fabrizio; Andreotti, A.; Sani, Francesco; Torricelli, Pietro; Gelmini, Roberta; Girardis, Massimo

doi:10.1016/j.radcr.2019.12.006

Cited by 10 publications

(4 citation statements)

References 16 publications

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“…As with other gadolinium contrast agents, gadobenate dimeglumine-induced allergies/allergic/ hypersensitivity reactions have been reported (11). Their severity varies, and they may be serious or life-threatening and can lead to anaphylactic shock (12) or even death. Adverse reactions may involve one or more organs and systems, including respiratory, cardiovascular, and/or skin and mucosal tissues (13), especially in patients with a history of asthma or other allergic diseases.…”

Section: Discussionmentioning

confidence: 99%

A case of gadobenate dimeglumine-induced anaphylactic shock: a case report

et al. 2021

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A 70-year-old man was admitted to our hospital due to "liver cirrhosis; grade 3 hypertension; pulmonary infection". On May 27, 2019, during upper abdomen plain and enhanced magnetic resonance imaging (MRI) and magnetic resonance cholangiopancreatography (MRCP), the patient experienced anaphylactic shock, manifested as sudden unconsciousness and lack of response, after intravenous administration of gadobenate dimeglumine (Multihance ® ). Gadobenate dimeglumine is a paramagnetic contrast used during diagnostic MRI. It has hepatobiliary specificity with very good imaging performance.A small amount is absorbed by normal liver cells after intravenous injection and excreted via the bile ducts while maintaining the chemical structure of gadobenate dimeglumine. It allows the visualization of local angiogenesis and perfusion, which reflect the hepatic blood supply and recent liver function, thereby providing a reference for clinical diagnosis. Gadobenate dimeglumine intravenous injection may cause adverse reactions such as nausea, dizziness, and anaphylactic shock. Anaphylactic shock is a known serious adverse reaction of gadobenate dimeglumine injection. In this paper, we report a case of gadobenate dimeglumine-induced anaphylactic shock based on the temporal relationship between the onset of symptoms and the injection. The patient received chest compressions and balloon-assisted ventilation in addition to rehydration and volume expansion and vasoactive drugs to maintain blood pressure, etc. The patient died despite treatments. In the clinical, physicians, nurses, and clinical pharmacists should closely monitor patients and promptly discontinue drug administration and provide symptomatic care in case of adverse reactions.

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Section: Discussionmentioning

confidence: 99%

A case of gadobenate dimeglumine-induced anaphylactic shock: a case report

et al. 2021

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“…These scanners may not be available in all hospitals and even if they are, they may be prioritised for other diseases, for example, cardiac conditions (MRI) or cancers (PET). MRI requires the use of gadolinium contrast which has the potential to cause contract reaction in a minority of patients 29 and PET scans have a radiation exposure. FDG-PET scanning also requires either a specific high-fat, low-carbohydrate diet, a period of fasting or a heparin infusion prior to scanning to increase the accuracy of the imaged metabolic update in the areas of cardiac sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

CASPA (CArdiac Sarcoidosis in PApworth) improving the diagnosis of cardiac involvement in patients with pulmonary sarcoidosis: protocol for a prospective observational cohort study

et al. 2020

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IntroductionSarcoidosis is a multisystem disease, predominantly affecting the lungs but can involve the heart, resulting in cardiac sarcoidosis (CS). Patients require MRI/Positron Emission Tomography (PET) scans for diagnosis. Echocardiography, ECG and Holter monitoring may be indicative but not diagnostic alone. Patients can present late with conduction defects, heart failure or sudden death. The CASPA (CArdiac Sarcoidosis in PApworth) study protocol aims to (1) use MRI to identify CS prevalence; (2) use speckle-tracking echocardiography, signal averaged ECG and Holter monitoring to look for diagnostic pathways; and (3) identify serum proteins which may be associated with CS.Methods and analysisParticipants with pulmonary sarcoidosis (and no known cardiac disease) from Royal Papworth Hospital will have the following: cardiac MRI with late gadolinium, two-dimensional transthoracic echocardiography with speckle tracking, signal averaged ECG and 24-hour Holter monitor. They will provide a serum sample for brain natriuretic peptide levels and proteomics by liquid chromatography coupled to high-resolution mass spectrometry. All data will be collected on OpenClinica platform and analysed approximately 6 months after final patient recruitment.Ethics and disseminationThe Camden & Kings Cross Research Ethics Committee approved the protocol (REC number: 17/LO/0667). Integrated Research Approval System (IRAS) 222 720. Dissemination of findings will be via conference presentations and submitted to peer-reviewed journals.

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“…They found this technique was successful at identifying PVS in a cohort of healthy individuals, and a cohort of patients with endolymphatic hydrops. 19 , 20 , 21 , 22 , 23 Gadolinium contrast is widely used for contrast‐enhanced neuroimaging in clinical practice but can be associated with a rare but life‐threatening allergy 24 and is contraindicated in renal impairment. Newer approaches utilizing endogenous contrast techniques may be superior to exogenous contrast such as gadolinium.…”

Section: Imaging the Glymatic Systemmentioning

confidence: 99%

Automated Methods for Detecting and Quantitation of Enlarged Perivascular spaces on MRI

Moses

Sinclair

Law

et al. 2022

Magnetic Resonance Imaging

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The brain's glymphatic system is a network of intracerebral vessels that function to remove “waste products” such as degraded proteins from the brain. It comprises of the vasculature, perivascular spaces (PVS), and astrocytes. Poor glymphatic function has been implicated in numerous diseases; however, its contribution is still unknown. Efforts have been made to image the glymphatic system to further assess its role in the pathogenesis of different diseases. Numerous imaging modalities have been utilized including two‐photon microscopy and contrast‐enhanced magnetic resonance imaging (MRI). However, these are associated with limitations for clinical use. PVS form a part of the glymphatic system and can be visualized on standard MRI sequences when enlarged. It is thought that PVS become enlarged secondary to poor glymphatic drainage of metabolites. Thus, quantitating PVS could be a good surrogate marker for glymphatic function. Numerous manual rating scales have been developed to measure the PVS number and size on MRI scans; however, these are associated with many limitations. Instead, automated methods have been created to measure PVS more accurately in different diseases. In this review, we discuss the imaging techniques currently available to visualize the glymphatic system as well as the automated methods currently available to measure PVS, and the strengths and limitations associated with each technique. Evidence Level 1 Technical Efficacy Stage 1

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Case report of a patient who survived after cardiac arrest and cardiogenic shock by anaphylactic reaction to gadolinium during magnetic resonance imaging

Cited by 10 publications

References 16 publications

A case of gadobenate dimeglumine-induced anaphylactic shock: a case report

A case of gadobenate dimeglumine-induced anaphylactic shock: a case report

CASPA (CArdiac Sarcoidosis in PApworth) improving the diagnosis of cardiac involvement in patients with pulmonary sarcoidosis: protocol for a prospective observational cohort study

Automated Methods for Detecting and Quantitation of Enlarged Perivascular spaces on MRI

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