title: Polyarthropathy--a delayed reaction to low osmolality angiographic contrast medium in patients with end stage renal disease.
abstract: Since the introduction of low osmolality non-ionic media, acute reactions to radiographic contrast are uncommon and delayed reactions are especially rare, consisting mostly of mild flu-like symptoms. We report two patients suffering from end-stage renal failure and treated by continuous ambulatory peritoneal dialysis (CAPD) who developed a severe constitutional illness including acute polyarthropathy 6 and 16 h after injection of the low osmolality non-ionic contrast medium, iopamidol. Although the clinical presentation of the reactions was similar to a systemic lupus syndrome there was no immunological evidence to support this as an aetiological mechanism. Since CAPD is a relatively inefficient method of clearing contrast media prolonged high circulating levels of iopamidol may have been a contributory factor to these unusually severe delayed contrast reactions.
authors.affiliation: Department of Surgery, Leicester General Hospital, UK.
authors.forename: P K
authors.initials: PK
authors.lastname: Donnelly
authors.forename: B
authors.initials: B
authors.lastname: Williams
authors.forename: E M
authors.initials: EM
authors.lastname: Watkin
mesh_terms: D000208:Acute Disease; D000368:Aged; D001168:Arthritis / Q000139:chemically induced*; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D010531:Peritoneal Dialysis, Continuous Ambulatory
chemical_list: D007479:Iopamidol