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非离子型低渗静脉造影剂注射后发生急性严重血小板减少症。

Acute severe thrombocytopenia following non-ionic low-osmolarity intravenous contrast medium injection.

机构信息

Department of Radiology and Oncotherapy, Semmelweis University, Budapest 1083, Hungary.

出版信息

Korean J Radiol. 2012 Jul-Aug;13(4):505-9. doi: 10.3348/kjr.2012.13.4.505. Epub 2012 Jun 18.

DOI:10.3348/kjr.2012.13.4.505
PMID:22778575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3384835/
Abstract

Intravenous contrast medium (ICM) rarely induces anaphylactic reactions, including urticaria, hypotension and respiratory failure. Even the most modern ICM may cause such adverse events. Thrombocytopenia has been reported as an extreme rare consequence of ICM. Here we report on a case of a 72-year-old male patient with a self-limiting severe acute thrombocytopenia following administration of intravenous non-ionic low-osmolarity contrast medium. No such low platelet count has ever been reported. We also present a review of the literature.

摘要

静脉造影剂(ICM)很少引起过敏反应,包括荨麻疹、低血压和呼吸衰竭。即使是最现代的 ICM 也可能引起此类不良事件。血小板减少症已被报道为 ICM 的一种极其罕见的后果。在这里,我们报告了一例 72 岁男性患者在静脉注射非离子型低渗造影剂后出现自限性严重急性血小板减少症的病例。从未报道过如此低的血小板计数。我们还回顾了文献。

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1
Acute severe thrombocytopenia following non-ionic low-osmolarity intravenous contrast medium injection.非离子型低渗静脉造影剂注射后发生急性严重血小板减少症。
Korean J Radiol. 2012 Jul-Aug;13(4):505-9. doi: 10.3348/kjr.2012.13.4.505. Epub 2012 Jun 18.
2
[Adverse reactions to contrast media for intravenous use. A comparison between ionic and nonionic media].[静脉用造影剂的不良反应。离子型与非离子型造影剂的比较]
Rev Med Panama. 1995 Jan-May;20(1-2):20-4.
3
Ionic versus nonionic contrast media: a prospective study of the effect of rapid bolus injection on nausea and anaphylactoid reactions.离子型与非离子型造影剂:快速推注对恶心和类过敏反应影响的前瞻性研究
J Comput Assist Tomogr. 1998 May-Jun;22(3):341-5. doi: 10.1097/00004728-199805000-00001.
4
Contrast-induced nephropathy-choice of contrast agents to reduce renal risk.对比剂肾病——降低肾脏风险的对比剂选择
Am Heart Hosp J. 2009 Summer;7(1):45-9. doi: 10.15420/ahhj.2009.7.1.45.
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Frequency and effects of extravasation of ionic and nonionic CT contrast media during rapid bolus injection.离子型和非离子型CT造影剂在快速团注过程中渗漏的频率及影响
Radiology. 1998 Mar;206(3):637-40. doi: 10.1148/radiology.206.3.9494479.
6
Is the use of intravenous contrast material truly safe in patients with impaired renal function?对于肾功能受损的患者,静脉使用造影剂真的安全吗?
Radiology. 2009 May;251(2):613; author reply 613-4. doi: 10.1148/radiol.2511081609.
7
[Experimental and clinical determination of renal size after intravenous and intra-arterial administration of ionic and non-ionic contrast media].[静脉内和动脉内注射离子型和非离子型造影剂后肾脏大小的实验与临床测定]
Rofo. 1985 Mar;142(3):333-7. doi: 10.1055/s-2008-1052659.
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Intravenous ionic contrast media cause local prostacyclin release in man.静脉注射离子型造影剂可导致人体局部释放前列环素。
Invest Radiol. 1985 Nov;20(8):871-3. doi: 10.1097/00004424-198511000-00017.
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Dose-related nephrotoxicity.剂量相关的肾毒性。
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[Adverse reactions following high-dose intravenous injection of urographic contrast media].[大剂量静脉注射尿路造影剂后的不良反应]
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Acute severe thrombocytopenia following iodinated radiographic contrast medium infusion: a case report.静脉输注碘化造影剂后发生急性严重血小板减少症:一例报告
Ann Med Surg (Lond). 2023 Feb 6;85(2):187-190. doi: 10.1097/MS9.0000000000000150. eCollection 2023 Feb.
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Contrast medium-induced severe thrombocytopenia in patient on maintenance hemodialysis: a case report and literature review.维持性血液透析患者造影剂致严重血小板减少症:病例报告及文献复习。
CEN Case Rep. 2020 Aug;9(3):266-270. doi: 10.1007/s13730-020-00468-8. Epub 2020 Apr 8.
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Management of Adverse Reactions to Iodinated Contrast Media for Computed Tomography in Korean Referral Hospitals: A Survey Investigation.

本文引用的文献

1
Frequency and severity of adverse effects of iodinated and gadolinium contrast materials: retrospective review of 456,930 doses.碘化造影剂和钆造影剂不良反应的发生率及严重程度:对456,930剂造影剂的回顾性研究
AJR Am J Roentgenol. 2009 Oct;193(4):1124-7. doi: 10.2214/AJR.09.2520.
2
Drug-induced immune thrombocytopenia.药物性免疫性血小板减少症
N Engl J Med. 2007 Aug 9;357(6):580-7. doi: 10.1056/NEJMra066469.
3
Thrombocytopenia following intravenous iopamidol.静脉注射碘帕醇后的血小板减少症。
韩国转诊医院 CT 用碘对比剂不良反应管理:调查研究。
Korean J Radiol. 2019 Jan;20(1):148-157. doi: 10.3348/kjr.2017.0771. Epub 2018 Dec 27.
4
Life-Threatening Thrombocytopenia Following Intravenous Contrast Media Infusion.静脉注射造影剂后出现危及生命的血小板减少症。
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Contrast-induced thrombocytopenia following percutaneous coronary intervention.经皮冠状动脉介入治疗后造影剂诱导的血小板减少症
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[Recurrent immune thrombocytopenia: a rare complication after contrast medium injection].复发性免疫性血小板减少症:造影剂注射后的罕见并发症
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5
Severe thrombocytopenia as a result of contrast left ventricular angiography.对比剂所致左心室造影导致的严重血小板减少症。
Cathet Cardiovasc Diagn. 1982;8(5):495-9. doi: 10.1002/ccd.1810080511.
6
Immune-mediated thrombocytopenia due to an iodinated contrast medium (diatrizoate).由碘化造影剂(泛影酸盐)引起的免疫介导性血小板减少症。
Can Med Assoc J. 1985 Jul 15;133(2):123.
7
Acute thrombocytopenia induced by parenteral radiographic contrast medium.静脉注射放射造影剂引起的急性血小板减少症。
AJR Am J Roentgenol. 1986 Jun;146(6):1298-9. doi: 10.2214/ajr.146.6.1298.
8
Acute thrombocytopenia after i.v. administration of a radiographic contrast medium.静脉注射造影剂后出现急性血小板减少症。
AJR Am J Roentgenol. 1989 May;152(5):947-9. doi: 10.2214/ajr.152.5.947.
9
[Effect of iodinated roentgen contrast media on coagulation, fibrinolysis and platelets].[碘化X线造影剂对凝血、纤维蛋白溶解及血小板的影响]
Arzneimittelforschung. 1977;27(11):2128-33.