Methylene blue: an effective treatment for contrast medium-induced anaphylaxis.
BACKGROUND
The purpose of this paper is to propose methylene blue as a lifesaving alternative drug for the treatment of contrast-induced anaphylaxis.


METHODS
In a cardiovascular catheterization laboratory invasive hemodynamic monitoring was used to document the lifesaving effect of IV bolus injections of 1.5-2 mg/Kg methylene blue solution to treat three patients for anaphylactic shock following radiocontrast injection during coronary angiography. Methylene blue administration was followed by prompt circulatory improvement, leading to hemodynamic stabilization and relief of other anaphylactic symptoms in each case. There were no deaths.


CONCLUSIONS
Our findings suggest that methylene blue can be lifesaving in anaphylactic shock, notwithstanding some transitory side effects, such as cardiac rhythm disturbances and chest pain, both of which possibly originate from sudden myocardial perfusion deficits.
Oliveira Neto
Antonio M
AM
Prodiagnóstico--Sao Gonçalo, RJ, Brazil.
Duarte
Neison M
NM
Vicente
Walter V A
WV
Viaro
Fernanda
F
Evora
Paulo R B
PR
D000707:Anaphylaxis / Q000139:chemically induced*; D003287:Contrast Media / Q000009:adverse effects*; D006152:Cyclic GMP / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D008751:Methylene Blue / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000378:metabolism
D003287:Contrast Media; D004791:Enzyme Inhibitors; D009569:Nitric Oxide; D006152:Cyclic GMP; D008751:Methylene Blue