Frequency and Severity of Acute Allergic-Like Reactions to Gadolinium-Containing IV Contrast Media in Children and Adults

• Published in: American journal of roentgenology (1976) Vol. 189; no. 6; pp. 1533 - 1538
• Main Authors: Dillman, Jonathan R, Ellis, James H, Cohan, Richard H, Strouse, Peter J, Jan, Sophia C
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01-12-2007; American Roentgen Ray Society
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; Contrast Media; Drug Hypersensitivity - classification; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - epidemiology; Female; Gadolinium; Humans; Incidence; Injections, Intravenous - statistics & numerical data; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging - statistics & numerical data; Male; Medical sciences; Michigan - epidemiology; Pneumology; Risk Assessment - methods; Risk Factors; Michigan; Human; Immunopathology; Lung disease; Allergy; Nuclear medicine; Respiratory disease; Acute; Gadolinium; Asthma; Radiology; Bronchus disease; Adult; Obstructive pulmonary disease; Child; Contrast media
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/AJR.07.2554

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.
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.
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.
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.