Anaphylactoid reaction after retrograde pyelography despite preoperative steroid preparation.
A 19-year-old woman with a known allergy to iodinated contrast presented with intermittent, gross hematuria of 2 years' duration. The patient was scheduled to undergo cystoscopy with bilateral retrograde pyelography, because this is considered a safe alternative to intravenous pyelography or computed tomography. Because of her contrast allergy, the patient completed a 13-hour steroid preparation before the procedure. However, within minutes of extubation, she developed an anaphylactoid reaction and, despite appropriate management, required reintubation and subsequent transfer to the intensive care unit. The patient was subsequently extubated 8 hours later and recovered completely.
Armstrong
Patrick A
PA
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611-3008, USA.
Pazona
Joseph F
JF
Schaeffer
Anthony J
AJ
D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced* / Q000517:prevention & control; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D003287:Contrast Media / Q000009:adverse effects*; D004155:Diphenhydramine / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007682:Kidney Pelvis / Q000000981:diagnostic imaging*; D011241:Prednisone / Q000627:therapeutic use*; D017211:Treatment Failure; D014567:Urography / Q000009:adverse effects / Q000379:methods
D018926:Anti-Allergic Agents; D003287:Contrast Media; D005938:Glucocorticoids; D004155:Diphenhydramine; D011241:Prednisone