Acute Adverse Reactions to Gadolinium-Based Contrast Agents: Based on 17,276 Contrast-Enhanced MR Examinations

Abstract

PURPOSE. We report gadolinium-based contrast agents (GBCAs) acute adverse drug reactions (ADRs) occurred in a regional teaching hospital and analyze the pattern and incidence of ADRs. MATERIALS AND METHODS. We analyzed all ADRs occurred in 17,276 patients who underwent contrast-enhanced magnetic resonance examination from April 1, 2014 to February 28, 2019. GBCAs used in this study included Gd-BOPTA, Gd- BTDO3A and Gd-DOTA. ADRs were classified mild, moderate, and severe according to the criteria issued by the American College of Radiology. RESULTS. A total of 43 (0.25%) patients had ADRs: 42 (0.24%) mild reaction, 1 moderate reaction. Incidence of ADR were 0.39, 0.23, and 0.18% for Gd-BOPTA, Gd-BTDO3A and Gd-DOTA, respectively. Previous history of allergy to food or drug was found in 35% of our patients with ADRs. The symptoms and signs in 22 patients resolved spontaneously, and other 21 cases resolved after treatment. None of these patient had sequelae. CONCLUSION. The ADRs induced by GBCAs are mainly mild. Only 1 moderate reaction and no severe ADRs are observed in this study. Close observation or premedication to patients with prior history of allergy to food or drugs may be considered because more than one third of our patients with ADRs had history of allergy to food or drug.