Imed Group Research Department, Av. Angélica, 2.530 - 9º andar, São Paulo, SP, 01228-200, Brazil.
Adult Intensive Care Unit, São Camilo Hospital, Pompeia Unit. Av. Pompéia, 1178, São Paulo, SP, 05022-001, Brazil.
J Med Case Rep. 2022 Nov 17;16(1):421. doi: 10.1186/s13256-022-03643-w.
Gadolinium-based contrast agents are used extensively in magnetic resonance imaging to assist diagnosis of medical conditions. Despite their documented safety profile, severe adverse events do occur, and their documentation may serve to raise the awareness of the medical community.
We report the case of a 15-year-old white Latin American female patient admitted to the intensive care unit for acute respiratory distress syndrome following administration of gadolinium. She did not have rash or tongue swelling but developed hypotension responsive to fluid administration and severe hypoxemia. Chest computed tomography revealed bilateral pulmonary compromise with multiple confluent consolidations. She received methylprednisolone and noninvasive ventilatory support including bilevel positive airway pressure ventilation and high-flow nasal cannula, and underwent a rapid recovery.
Gadolinium-based contrast agent-induced acute respiratory distress syndrome, albeit rare, should be included in the differential diagnosis of respiratory failure shortly after magnetic resonance imaging, which is nowadays a frequent diagnostic procedure, potentially increasing the awareness of this serious complication.
钆基造影剂在磁共振成像中被广泛用于协助诊断医疗状况。尽管已有其安全性记录，但仍会发生严重的不良反应，其记录可能有助于提高医学界的认识。
我们报告了一例 15 岁的白人拉丁裔女性患者的病例，她在接受钆剂治疗后因急性呼吸窘迫综合征入住重症监护病房。她没有皮疹或舌肿胀，但出现低血压，对液体治疗有反应，并伴有严重的低氧血症。胸部计算机断层扫描显示双侧肺损伤，多个融合性实变。她接受了甲基强的松龙和无创通气支持，包括双水平正压通气和高流量鼻导管，并且快速恢复。
尽管钆基造影剂引起的急性呼吸窘迫综合征很少见，但在磁共振成像后不久，应将其纳入呼吸衰竭的鉴别诊断中，磁共振成像现在是一种常见的诊断程序，可能会提高对这种严重并发症的认识。
