Contrast-induced encephalopathy and seizures in a patient with chronic renal insufficiency.
Radiographic contrast agents are associated with a number of adverse effects, including central nervous system effects and seizures. Almost all contrast agents are primarily filtered and excreted by the kidneys, and they accumulate in patients with end-stage renal disease. Brain retention of contrast associated with high doses is a rare event, having been reported only twice in the literature. We report a case of a 49-year-old male on chronic hemodialysis who developed brain retention of contrast resulting in seizures and encephalopathy after receiving large doses of meglumine/sodium diatrizoate during coronary angiography. He was treated successfully with hemodialysis and suffered no permanent neurologic sequelae. Patients with end-stage renal disease may be at increased risk of adverse effects from contrast when administered in high doses.
Muruve
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DA
Department of Medicine, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215, USA.
Steinman
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TI
D001927:Brain Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D003973:Diatrizoate / Q000009:adverse effects*; D003974:Diatrizoate Meglumine / Q000009:adverse effects*; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012640:Seizures / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D004338:Drug Combinations; D003973:Diatrizoate; D003974:Diatrizoate Meglumine; C027278:urovision