Frequency and severity of acute allergic-like reactions to gadolinium-containing i.v. contrast media in children and adults.
OBJECTIVE
The purpose of our study was to determine the frequency and severity of acute allergic-like reactions to i.v.-administered gadolinium-containing contrast media in children and adults.


METHODS
Pediatric (younger than 19 years) and adult department of radiology contrast material reaction forms involving patients who experienced acute allergic-like reactions to gadolinium-containing contrast media from January 1, 2001, through December 31, 2006, were retrospectively evaluated for the specific types of acute allergic-like reactions, reaction management, and patient outcomes. Relevant patient medical information, including documentation of prior gadolinium- or iodine-containing contrast material reaction, premedication before acute allergic-like reaction to i.v. gadolinium-containing contrast material, previous allergic reactions to substances other than contrast media, and history of asthma, was obtained by reviewing electronic medical records.


RESULTS
Seventy-eight thousand three hundred fifty-three (65,009 adult and 13,344 pediatric) i.v. administrations of gadolinium-containing contrast material were performed during the study period. Acute allergic-like reactions were documented after 54 injections (reaction frequency, 0.07%). Forty-eight reactions involved adult patients (adult reaction frequency, 0.07%), and six reactions occurred in pediatric patients (pediatric reaction frequency, 0.04%). Forty (74%) acute allergic-like reactions were mild, 10 (19%) were moderate, and four (7%) were severe. No gadolinium-containing contrast material-related death occurred during the study period. Twenty-six (50%) of 52 patients had one or more presumed risk factors for contrast material reaction.


CONCLUSIONS
Adult and pediatric acute allergic-like reactions to i.v.-administered gadolinium-containing contrast media are rare. Most of these reactions are mild; however, moderate and severe reactions that require immediate management do occur.
Dillman
Jonathan R
JR
Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr., Ann Arbor, MI 48109, USA. jonadill@med.umich.edu
Ellis
James H
JH
Cohan
Richard H
RH
Strouse
Peter J
PJ
Jan
Sophia C
SC
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D004342:Drug Hypersensitivity / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005682:Gadolinium; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous / Q000706:statistics & numerical data; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
D003287:Contrast Media; D005682:Gadolinium