title: Adverse allergic reactions to linear ionic gadolinium-based contrast agents: experience with 194, 400 injections.
abstract: OBJECTIVE
  To report the authors' experience with the administration of four gadolinium-based contrast agents (GBCA; gadopentetate dimeglumine, gadofosveset trisodium, gadoxetate disodium and gadobenate dimeglumine) in a large study population at a single, large academic medical centre.
  
  
  METHODS
  The institutional review board approved this retrospective study in which data in the electronic incident reporting system were searched. A total of 194, 400 intravenous administrations of linear ionic GBCAs were assessed for the incidence of adverse reactions and risk factors from 1 January 2007 to 14 January 2014. The severity of reactions (mild, moderate, and severe), patient type (outpatients, inpatients, and emergency), examination type, and treatment options were also investigated.
  
  
  RESULTS
  In total, 204/194400 (0.1%) patients (mean age 45.7 ± 14.9) showed adverse reactions, consisting of 6/746 (0.80%), 10/3200 (0.31%), 14/6236 (0.22%) and 174/184218 (0.09%), for gadofosveset trisodium, gadoxetate disodium, gadobenate dimeglumine, and gadopentetate dimeglumine, respectively. An overall significant difference was found between different GBCAs regarding the total number of reactions (p < 0.0001). When comparing the GBCAs together, significant differences were found between gadofosveset trisodium versus gadopentetate dimeglumine (p < 0.0001), gadofosveset trisodium versus gadobenate dimeglumine (p = 0.0051), gadoxetate disodium versus gadopentetate dimeglumine (p < 0.0001) and gadopentetate dimeglumine versus gadobenate dimeglumine (p = 0.0013). Rate of reaction was higher in females (F: 146/113187, 0.13%/M: 58/81213, 0.07%; p < 0.0001). Rate of reactions was higher in outpatient (180/158885, 0.11%), emergency (10/10413, 0.10%), and inpatients (14/25102, 0.05%), respectively (p < 0.0001). Most of the patients had mild symptoms 171/204 (83.8%). Abdomen-pelvis, liver, and thoracic examinations had highest rates of reactions (0.17 versus 0.16 versus 0.15).
  
  
  CONCLUSIONS
  The overall rate of adverse reaction to GBCAs was 0.1%. The rates of reactions were highest in gadofosveset trisodium with (0.80%), followed by gadoxetate disodium (0.31%), gadobenate dimeglumine (0.22%) and gadopentetate dimeglumine (0.09%).
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Founders Building, Room 210, Boston, MA 02114, USA.
authors.forename: S
authors.initials: S
authors.lastname: Aran
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Founders Building, Room 210, Boston, MA 02114, USA.
authors.forename: K W
authors.initials: KW
authors.lastname: Shaqdan
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Founders Building, Room 210, Boston, MA 02114, USA. Electronic address: Abujudeh.Hani@mgh.harvard.edu.
authors.forename: H H
authors.initials: HH
authors.lastname: Abujudeh
mesh_terms: D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity; D005260:Female; D005682:Gadolinium / Q000009:adverse effects*; D019786:Gadolinium DTPA / Q000009:adverse effects*; D006801:Humans; D007267:Injections; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium; D019786:Gadolinium DTPA; C109932:gadofosveset trisodium