Severe liver and renal injuries following cerebral angiography: late life-threatening complications of non-ionic contrast medium administration.
BACKGROUND
Contrast-induced nephropathy requiring dialysis support is rarely reported, whereas severe liver injury after contrast agent administration has not been described in children yet.


METHODS
A previously healthy 10-year-old boy with diagnosis of cerebral arteriovenous malformation underwent a cerebral angiogram study with iohexol (3 mL/kg). After 4 days, he developed vomiting and abdominal pain. Laboratory results showed abnormal liver function tests, including marked elevation of transaminases. In the next day, he evolved with oliguria and blood arterial hypertension. At this time, he presented with worsening renal function tests. Peritoneal dialysis was required for 13 days. The patient had a self-limiting course and received only supportive treatment.


METHODS
This report highlights delayed complications related to low non-ionic contrast media with a rare presentation that can be neglected or unrecognized by pediatric specialties.
Pediatric Intensive Care Unit, Hospital Estadual de Diadema, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. psls.nat@terra.com.br.|Pediatric Intensive Care Unit, Rua José Bonifácio 1641, Diadema, São Paulo, Brazil, 099800-150. psls.nat@terra.com.br.
Paulo Sergio Lucas
PS
da Silva
Pediatric Intensive Care Unit, Hospital Estadual de Diadema, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Emerson Yukio
EY
Kubo
Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Marcelo Cunio Machado
MC
Fonseca
D002533:Cerebral Angiography / Q000009:adverse effects*; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000150:complications / Q000209:etiology*; D008107:Liver Diseases / Q000150:complications / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed
D003287:Contrast Media
Children; Contrast media; Liver; Renal failure