title: [Use of gadolinium as contrast agent in endoscopic retrograde cholangiopancreatography in patients with iodine allergy].
abstract: BACKGROUND
  Radiologic contrasts are required during endoscopic retrograde cholangiopancreatography (ERCP). The most frequently used are iodine-based contrast media. Controversy still surrounds the optimal strategy in patients with previous adverse reactions to iodine contrasts that need to undergo an ERCP.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of a gadolinium-derived contrast medium in patients with previous reactions to iodine-derived agents during ERCP.
  
  
  METHODS
  Thirteen ERCP were performed in 11 patients with well-established adverse reactions to iodine compounds. ERCP was carried out with gadobutrol, a non-ionic gadolinium compound and without prophylaxis.
  
  
  RESULTS
  In all patients, ERCP were satisfactorily completed. Thirteen cholangiograms and one pancreatogram were obtained. All procedures were technically successful, allowing diagnosis and endotherapy. The quality of the images was good, similar to those obtained with standard contrast media, and did not represent a limitation. No contrast-related adverse events were observed, and there were no post-ERCP complications.
  
  
  CONCLUSIONS
  Gadolinium-derived agents are a safe and effective alternative in iodine-allergic patients.
authors: Servicio de Aparato Digestivo, Hospital Universitario La Paz, Madrid, España. emartina.hulp@salud.madrid.org
authors: Eduardo
authors: E
authors: Martín Arranz
authors: Rafael
authors: R
authors: Rey Sanz
authors: María Dolores
authors: MD
authors: Martín Arranz
authors: Francisco
authors: F
authors: Gea Rodríguez
authors: Pedro
authors: P
authors: Mora Sanz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003287:Contrast Media; D004342:Drug Hypersensitivity / Q000209:etiology; D005260:Female; D005682:Gadolinium; D006801:Humans; D017613:Iodine Compounds / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds
chemical_list: D003287:Contrast Media; D017613:Iodine Compounds; D009942:Organometallic Compounds; C090600:gadobutrol; D005682:Gadolinium