An immediate generalized reaction to iopamidol.
Intravascularly administered lower-osmolality contrast media cause fewer adverse effects than do higher-osmolality media. Immediate generalized reactions such as acute urticaria or bronchospasm have been documented occasionally in patients receiving lower-osmolality contrast media. To our knowledge, this is the first reported case of an immediate generalized reaction to a lower-osmolality contrast medium in which significant hypotension also occurred. During cardiac catheterization, in a patient who had never been exposed to a contrast medium, a 69-year old man developed chest tightness, periorbital and facial edema, slight uvular edema, and a decline in blood pressure from 150/71 to 97/67 mm Hg. Epinephrine hydrochloride, diphenhydramine hydrochloride, and hydrocortisone were administered. The lack of absolute safety of lower-osmolality contrast media emphasizes the need for clinical awareness and availability of emergency therapy when these agents are utilized.
Department of Medicine, /sections of /allergy-Immunology and Cardiology, Northwestern University Medical School, Chicago.
P A
PA
Greenberger
L
L
Gutt
N M
NM
Sheridan
D000368:Aged; D006328:Cardiac Catheterization; D004155:Diphenhydramine / Q000627:therapeutic use; D004837:Epinephrine / Q000627:therapeutic use; D006321:Heart / Q000000981:diagnostic imaging; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007479:Iopamidol / Q000009:adverse effects*; D008297:Male; D011859:Radiography
D004155:Diphenhydramine; D007479:Iopamidol; D006854:Hydrocortisone; D004837:Epinephrine