title: Level of plasma prekallikrein and its inhibitors in reactors and nonreactors during intravenous enhancement with contrast media.
abstract: Complex contact activation systems may play a major role in the side effects of i.v. contrast media (CM). This is why quantitative measurements of several factors (plasma prekallikrein, hematocrit (hct), alpha-2-macroglobulin, alpha-1-antitrypsin, and C1-esterase inhibitor) were determined prior to and following the injection of CM during body CT examination in 5 patient groups, each (n = 10) receiving one of 5 different CM, including ioxaglate, meglumine iodamide, metrizamide, iohexol, and meglumine diatrizoate. The initial plasma prekallikrein level was available from 45 patients and was statistically lower in reactors (mean 90.6 mumol TAMe/ml/h; n = 13) than in nonreactors (mean 107 mumol TAMe/ml/h; n = 32) (p = 0.006), but there was no statistically significant difference in the decrease of plasma prekallikrein before and at 5 min after the injection for those 2 groups. The initial plasma C1-esterase inhibitor level was lower in reactors, while the plasma alpha-2-macroglobulin level was higher in that group than in nonreactors. The results indicate that the measurement of plasma prekallikrein combined with plasma C1-esterase inhibitor and alpha-2-macroglobulin measurement could be useful when predicting which patients are prone to CM reactions.
authors.affiliation: Department of Diagnostic Radiology, Helsinki University Central Hospital, Finland.
authors.forename: H J
authors.initials: HJ
authors.lastname: Aronen
authors.forename: L
authors.initials: L
authors.lastname: Kivisaari
authors.forename: I
authors.initials: I
authors.lastname: Torstila
authors.forename: T
authors.initials: T
authors.lastname: Paavonen
authors.forename: S
authors.initials: S
authors.lastname: Meri
authors.forename: S L
authors.initials: SL
authors.lastname: Karonen
authors.forename: C G
authors.initials: CG
authors.lastname: Standertskjöld-Nordenstam
mesh_terms: D001798:Blood Proteins / Q000187:drug effects*; D003174:Complement C1 Inactivator Proteins / Q000187:drug effects; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D011288:Prekallikrein / Q000187:drug effects*; D000515:alpha 1-Antitrypsin / Q000187:drug effects; D000511:alpha-Macroglobulins / Q000187:drug effects
chemical_list: D001798:Blood Proteins; D003174:Complement C1 Inactivator Proteins; D003287:Contrast Media; D000515:alpha 1-Antitrypsin; D000511:alpha-Macroglobulins; D011288:Prekallikrein