title: Severe systemic reaction to diphosphonate bone imaging agents: skin testing to predict allergic response and a safe alternative agent.
abstract: We describe a severe systemic reaction which occurred in a patient on two occasions after i.v. injection of chemically related diphosphonate bone imaging agents. Skin testing showed reactivity to multiple commercially available diphosphonate compounds but no significant response to pyrophosphates. A subsequent pyrophosphate bone scan resulted in no adverse reaction. Severe systemic reactions to diphosphonates can occur, skin testing may prove useful in evaluating allergic reactions, and pyrophosphates appear to be a safe alternative agent in patients proven or suspected allergic to diphosphonates.
mesh_terms: D000328:Adult; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D011756:Diphosphates / Q000009:adverse effects; D004164:Diphosphonates / Q000009:adverse effects; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D012882:Skin Tests; D013667:Technetium; D013669:Technetium Tc 99m Medronate / Q000009:adverse effects*; D016698:Technetium Tc 99m Pyrophosphate
chemical_list: D011756:Diphosphates; D004164:Diphosphonates; D016698:Technetium Tc 99m Pyrophosphate; D013667:Technetium; D013669:Technetium Tc 99m Medronate