Angiographic contrast agent-induced acute hemolysis in a patient with hemoglobin SC disease.
Radiographic contrast media used for angiographic procedures are hyperosmolar and induce sickling in vitro of erythrocytes from patients with sickle cell disorders. We treated a 51-year-old black woman with hemoglobin SC disease, but without a history of painful crises, who developed severe intravascular hemolysis and pulmonary infiltrates following administration of a contrast agent for coronary angiography and ventriculography. This case emphasizes the potential for severe complications following administration of the currently available contrast agents to patients with sickle cell disease. We suggest that newer contrast agents with lower osmolality than the commonly used ones need to be carefully evaluated for radiologic studies in patients with sickle cell disease.
D000743:Anemia, Hemolytic / Q000139:chemically induced*; D000755:Anemia, Sickle Cell / Q000097:blood*; D000792:Angiography; D002932:Cineangiography; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003973:Diatrizoate / Q000009:adverse effects* / Q000031:analogs & derivatives*; D003974:Diatrizoate Meglumine / Q000009:adverse effects*; D004338:Drug Combinations / Q000009:adverse effects; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006450:Hemoglobin SC Disease / Q000097:blood* / Q000150:complications; D006801:Humans; D008875:Middle Aged
D003287:Contrast Media; D004338:Drug Combinations; D003973:Diatrizoate; D003974:Diatrizoate Meglumine; C027278:urovision