title: Contrast induced neurotoxicity following coronary angiogram with Iohexol in an end stage renal disease patient.
abstract: Neurotoxicity is an infrequent adverse reaction to iodinated contrast agents. Contrast induced neurotoxicity following coronary angiogram is very rare. Renal disease is a risk factor for contrast induced neurotoxicity. We report a case of contrast induced neurotoxicity following coronary angiogram and intervention using Iohexol (Omnipaque 350) in an end stage renal disease patient on peritoneal dialysis who had prior exposure to iodinated contrast without any adverse reaction. Hemodialysis had to be initiated for rapid removal of the contrast agent with subsequent complete resolution of neurological deficits. This case highlights the need for interventionalists to be aware of an important adverse reaction to iodinated contrast agents, especially in individuals with renal dysfunction, and that neurotoxicity is a possibility even with prior uneventful exposures. The role and timing of hemodialysis in contrast induced neurotoxicity in patients with chronic kidney disease and in those without chronic kidney disease needs further deliberation.
authors.affiliation: Narasimha Swamy Gollol Raju, Department of Internal Medicine, East Carolina University-Brody School of Medicine, Greenville, NC 27834, United States.
authors.forename: Narasimha Swamy
authors.initials: NS
authors.lastname: Gollol Raju
authors.affiliation: Narasimha Swamy Gollol Raju, Department of Internal Medicine, East Carolina University-Brody School of Medicine, Greenville, NC 27834, United States.
authors.forename: Deepak
authors.initials: D
authors.lastname: Joshi
authors.affiliation: Narasimha Swamy Gollol Raju, Department of Internal Medicine, East Carolina University-Brody School of Medicine, Greenville, NC 27834, United States.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Daggubati
authors.affiliation: Narasimha Swamy Gollol Raju, Department of Internal Medicine, East Carolina University-Brody School of Medicine, Greenville, NC 27834, United States.
authors.forename: Assad
authors.initials: A
authors.lastname: Movahed
keywords: Coronary angiogram; End stage renal disease; Hemodialysis; Iodinated contrast agent; Neurotoxicity