Severe thrombocytopenia as a result of contrast left ventricular angiography

Wein, Paul; Handler, Martin; Chadda, Kul D.

doi:10.1002/ccd.1810080511

Cited by 11 publications

(5 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…101,103 However, the physiologic status of individual patients and predisposing factors contribute significantly to the overall severity of the observed adverse reactions. 112,113,132,134,191,199,200 For example, patients with parapro teinemia are very susceptible to the effects of con trast agents, with severe renal failure being observed in these patients. 151 Similarly, patients with sickle cell disease and polycythemia vera exhibit severe rheologic disturbances after contrast media infu sion.…”

Section: Fig 23 Reactions To Contrast Media and Their Manage Mentmentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

View full text Add to dashboard Cite

Currently used routine laboratory screening methods are not reliable in the prediction of contrast media-related adverse reactions. Cost-effective laboratory methods for various molecular markers of pathophysiologic activation have now become available. In vitro activation tests in high-risk patients may prove to be useful in the prediction of contrast-induced activation of various adverse reactions. If prior clinical evaluation of a patient suggests an ongoing pathologic process, profiling of the following molecular markers may prove to be useful and helpful in avoiding contrast-induced adverse reactions: Fibrinopeptide A, platelet factor 4, thromboxane B2, 5-HETE, physiologic inhibitors of proteases, B beta 15-42 related peptides, bradykinin/kininogen, and anaphylactozins. In patients suspected of reacting to contrast agents, a small dose of 1 to 5 ml can be injected as a bolus and molecular marker profiling on blood drawn after the infusion may prove to be useful screening tests. Additional clinical studies are needed to prove this. However, this screening test should be performed with extreme caution, since some of the patients are known to react to as little as 1 ml dose. The safety of newly developed nonionic contrast agents can be readily assessed by profiling various molecular markers of adverse reactions, which provide a more reliable and quantitative assessment of contrast-induced adverse reactions. Based on molecular marker profiling, various prophylactic agents can be given to high-risk patients to avoid contrast-induced adverse reactions.

show abstract

Section: Fig 23 Reactions To Contrast Media and Their Manage Mentmentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

View full text Add to dashboard Cite

show abstract

“…Acute severe thrombocytopenia is an extremely rare and severe adverse complication induced by contrast media. To the best of our knowledge, 16 cases of this serious adverse reaction have been reported with different types of contrast media since the early 1980s (Table 3) [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. In most patients, any symptoms, including bleeding, fever, chills, dyspnea, wheezing, abdominal pain, and blood pressure variability, were observed within 24 h after contrast administration and the platelet count was decreased to below 10,000/ μl.…”

Section: Discussionmentioning

confidence: 99%

“…The lowest reported value of the platelet count was 0/ μl [16]. With regard to treatment, high-dose intravenous corticosteroids, which are widely used in management of anaphylaxis, were used in nine patients [2,4,6,7,10,12,13,16,17]. Eight patients received platelet transfusions [3, 5-8, 10, 12, 17].…”

Section: Discussionmentioning

confidence: 99%

Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

et al. 2020

View full text Add to dashboard Cite

A 43-year-old male patient on maintenance hemodialysis had an enhanced computed tomography scan examination with iohexol for the first time 10 min before regular hemodialysis therapy. At the start of hemodialysis, no symptoms were observed, and the platelet count was 148,000/μl. Approximately 1 h after starting hemodialysis, dyspnea and chest discomfort appeared. Since oxygen saturation of the peripheral artery decreased to 87%, oxygen administration was immediately started while continuing hemodialysis therapy. Furthermore, gingival hemorrhage was observed, and the platelet count decreased to 5000/μl. We were carefully monitoring his conditions while continuing hemodialysis and oxygen administration, but no further deterioration was observed. Thereafter, these symptoms and severe thrombocytopenia gradually improved without additional treatment. At the end of hemodialysis, these symptoms completely disappeared. As well, the platelet count recovered to 35,000/μl at the end of hemodialysis and increased to 92,000/μl the next morning. From the clinical course, we diagnosed with contrast medium-induced thrombocytopenia. Acute thrombocytopenia is a rare complication induced by the contrast medium. Until now, 16 cases on contrast medium-induced thrombocytopenia have been reported. Our case spontaneously recovered from severe thrombocytopenia relatively earlier than previous reports. Our patient started hemodialysis therapy 10 min after an enhanced computed tomography examination. Early removal of contrast medium by hemodialysis might be associated with early improvement. We should acknowledge that contrast media have potential to induce severe thrombocytopenia, even in patients on maintenance hemodialysis.

show abstract

“…Authors of papers from the nineteen eighties reported acute thrombocytopenia as a complication of iodinated contrast medium (2-5). Severe thrombocytopenia and recurrent thrombocytopenia are considered rare complications of ICM (1, 8).…”

Section: Discussionmentioning

confidence: 99%

Acute Severe Thrombocytopenia Following Non-Ionic Low-Osmolarity Intravenous Contrast Medium Injection

Bata

Tárnoki

et al. 2012

Korean J Radiol

View full text Add to dashboard Cite

Intravenous contrast medium (ICM) rarely induces anaphylactic reactions, including urticaria, hypotension and respiratory failure. Even the most modern ICM may cause such adverse events. Thrombocytopenia has been reported as an extreme rare consequence of ICM. Here we report on a case of a 72-year-old male patient with a self-limiting severe acute thrombocytopenia following administration of intravenous non-ionic low-osmolarity contrast medium. No such low platelet count has ever been reported. We also present a review of the literature.

show abstract

Severe thrombocytopenia as a result of contrast left ventricular angiography

Cited by 11 publications

References 7 publications

Molecular Markers of Contrast Media-Induced Adverse Reactions

Molecular Markers of Contrast Media-Induced Adverse Reactions

Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review

Acute Severe Thrombocytopenia Following Non-Ionic Low-Osmolarity Intravenous Contrast Medium Injection

Contact Info

Product

Resources

About