Abstract
Systemic reactions to radiocontrast media (RCM) administration are not a rare clinical occurrence. Most of these reactions involve some combination of pulmonary, cardiovascular, gastrointestinal, and cutaneous symptoms that can be life-threatening if not promptly and properly treated. These reactions involve systemic mast cell activation, histamine release, but not specific IgE, and are most accurately termed anaphylactoid . 29 It is estimated that up to 1% of all subjects receiving standard RCM (i.e., ionic, hyperosmolar solutions) experience clinically significant anaphylactoid reactions. Such reactions should be distinguished from vasomotor reactions, which occur in 5% to 8% of patients undergoing RCM-based procedures, and consist of nausea (with or without vomiting), flushing and warmth but no hypotension, urticaria, or airway obstruction. 15 Life-threatening RCM reactions occur less frequently (rate less than 0.1%), and actual fatalities are fortunately rare (0.03% to 0.001%, depending on the specific procedure). Even with the development of less hypertonic agents, RCM reactions still occur and can have alarming, even fatal, consequences. This article reviews the pathophysiology, clinical presentations, and management of RCM reactions.
Published Version
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