Tolerance data of Gd-DTPA: a review

Niendorf, H.P.; Dinger, Jürgen; Haustein, Jens; Cornelius, Iwan; Alhassan, A; Clauß, W.

doi:10.1016/0720-048x(91)90049-2

Cited by 125 publications

(50 citation statements)

References 1 publication

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“…In prior reports, immediate hypersensitivity reactions to MR contrast media were 2.3 to 3.7 times more likely in patients with allergies or asthma (20,21). This tendency is similar to that of iodinated contrast media, where hypersensitivity reactions were reported (11).…”

Section: Clinical Characteristics According To Immediate Hypersensitimentioning

confidence: 56%

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Jung¹,

Kang²,

Kim³

et al. 2012

Radiology

223

165

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Purpose:To determine the incidence and risk factors of immediate hypersensitivity reactions to gadolinium-based magnetic resonance (MR) contrast agents. Materials and Methods:Institutional review board approval and a waiver of informed consent were obtained. A retrospective study of patients who had been given gadolinium-based MR contrast media between August 2004 and July 2010 was performed by reviewing their electronic medical records. In addition to data on immediate hypersensitivity reaction, the kinds of MR contrast media and demographic data including age, sex, and comorbidity were collected. To compare the groups, the x 2 test, Fisher exact test, x 2 test for trend, Student t test, analysis of variance test, and multiple logistic regression test were performed. Results:A total of 112 immediate hypersensitivity reactions (0.079% of 141 623 total doses) were identified in 102 patients (0.121% of 84 367 total patients). Among the six evaluated MR contrast media, gadodiamide had the lowest rate (0.013%) of immediate hypersensitivity reactions, while gadobenate dimeglumine had the highest rate (0.22%). The rate for immediate hypersensitivity reactions was significantly higher in female patients (odds ratio = 1.687; 95% confidence interval: 1.143, 2.491) and in patients with allergies and asthma (odds ratio = 2.829; 95% confidence interval: 1.427, 5.610). Patients with a previous history of immediate hypersensitivity reactions had a higher rate of recurrence after reexposure to MR contrast media (30%) compared with the incidence rate in total patients (P , .0001). The incidence of immediate hypersensitivity reactions increased depending on the number of times patients were exposed to MR contrast media (P for trend = .036). The most common symptom was urticaria (91.1%), and anaphylaxis occurred in 11 cases (9.8%). The mortality rate was 0.0007% because of one fatality. Conclusion:The incidence of immediate hypersensitivity reactions to MR contrast media was 0.079%, and the recurrence rate of hypersensitivity reactions was 30% in patients with previous reactions.q RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Clinical Characteristics According To Immediate Hypersensitimentioning

confidence: 56%

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Jung¹,

Kang²,

Kim³

et al. 2012

Radiology

223

165

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“…It should be noted, however, that this is double that in the original formulation, a change made to reduce the transient, dose-dependent elevation in serum iron and bilirubin seen after injection of this agent. 30 Publications continued in the 1990s and 2000s detailing the difference in stability between the linear and macrocyclic agents, as revealed by transmetallation, 31 biodistribution, 32 and subchronic toxicity-the latter in animals. 33 A transmetallation study with zinc citrate demonstrated major differences between GBCAs, unexplained by equilibrium thermodynamics or selectivity constants, with the order of kinetic stability being macrocyclic > linear ionic > linear nonionic.…”

Section: Stability (And Nephrogenic Systemic Fibrosis)mentioning

confidence: 99%

Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus

Runge

2016

Investigative Radiology

144

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The established class of intravenous contrast media for magnetic resonance imaging is the gadolinium chelates, more generally referred to as the gadolinium-based contrast agents (GBCAs). These can be differentiated on the basis of stability in vivo, with safety and tolerability of the GBCAs dependent upon chemical and biologic inertness. This review discusses first the background in terms of development of these agents and safety discussions therein, and second their relative stability based both on in vitro studies and clinical observations before and including the advent of nephrogenic systemic fibrosis. This sets the stage for the subsequent focus of the review, the current knowledge regarding accumulation of gadolinium in the brain and specifically the dentate nucleus after intravenous administration of the GBCAs and differentiation among agents on this basis. The information available to date, from the initial conception of these agents in 1981 to the latest reports concerning safety, demonstrates a significant difference between the macrocyclic and linear chelates. The review concludes with a discussion of the predictable future, which includes, importantly, a reassessment of the use of the linear GBCAs or a subset thereof.

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“…Dillman et al (1) reported that although the difference is statistically insignificant, female patients experienced more acute allergic-like reactions, while Jung et al (4) reported that the proportion of male patients experiencing immediate hypersensitivity reactions increased as the severity of the reactions increased. Additionally, a history of asthma and various allergies are suggested to be the risk factors for adverse reactions (6,7). A previous study also indicated that the creatinine level tended to be higher in patients with more severe immediate hypersensitivity reactions (4).…”

Section: Discussionmentioning

confidence: 99%

A Case Report on a Severe Anaphylaxis Reaction to Gadolinium-Based MR Contrast Media

Park

Kim

Park

et al. 2017

J Korean Soc Radiol

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Acute hypersensitivity reactions to gadolinium-based magnetic resonance (MR) contrast media have been shown to have a much lower incidence and they are generally milder in terms of severity than acute adverse reactions associated with the use of iodinated contrast media for computed tomography scans. However, even though it is rare, a severe hypersensitivity reaction to MR contrast media can occur. Here we present the case of a 66-year-old woman who experienced a severe hypersensitivity reaction after administration of gadolinium-based contrast media without a previous history of allergies.

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Tolerance data of Gd-DTPA: a review

Cited by 125 publications

References 1 publication

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Safety of the Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging, Focusing in Part on Their Accumulation in the Brain and Especially the Dentate Nucleus

A Case Report on a Severe Anaphylaxis Reaction to Gadolinium-Based MR Contrast Media

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