An immediate generalized reaction to iopamidol.

Author(s): Greenberger PA, Gutt L, Sheridan NM

Affiliation(s): Department of Medicine, /sections of /allergy-Immunology and Cardiology, Northwestern University Medical School, Chicago.

Publication date & source: 1987-12, Arch Intern Med., 147(12):2208-9.

Publication type: Case Reports

Intravascularly administered lower-osmolality contrast media cause fewer adverse effects than do higher-osmolality media. Immediate generalized reactions such as acute urticaria or bronchospasm have been documented occasionally in patients receiving lower-osmolality contrast media. To our knowledge, this is the first reported case of an immediate generalized reaction to a lower-osmolality contrast medium in which significant hypotension also occurred. During cardiac catheterization, in a patient who had never been exposed to a contrast medium, a 69-year old man developed chest tightness, periorbital and facial edema, slight uvular edema, and a decline in blood pressure from 150/71 to 97/67 mm Hg. Epinephrine hydrochloride, diphenhydramine hydrochloride, and hydrocortisone were administered. The lack of absolute safety of lower-osmolality contrast media emphasizes the need for clinical awareness and availability of emergency therapy when these agents are utilized.