Qiu Lin, Cui Qihao, Gong Xuepeng, Zhou Haiyun
Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
J Asthma Allergy. 2023 Jan 25;16:195-200. doi: 10.2147/JAA.S386811. eCollection 2023.
Iodixanol-induced anaphylactic reaction is a well-known adverse event of contrast agents, which are generally well-tolerated and reversible. Serious and fatal reactions such as anaphylactic shock after computed tomography (CT) enhancement have been described. However, there is no data on these events in the literature.
This report describes a case of a serious anaphylactic reaction, possibly related to iodixanol and provides an overview of case reports.
A 47-year-old women who experienced persistent abdominal pain for more than one month, was proposed of hiatal hernia with CT images taken two weeks previously and was admitted to the gastrointestinal surgery department. The patient underwent contrast-enhanced abdominal CT for the evaluation of multiple intraperitoneal hemodynamic features. A few minutes after abdominal enhanced CT scan, the patient was pale, sweating, had muscle tension and trembling, even coma and profound hypotension with 90/43 mm Hg. Immediately she was supported with oxygen inhalation, was treated with adrenaline subcutaneously, dexamethasone intravenously, and rapid intravenous drip of compound sodium chloride. Ten minutes later, the patient was in respiratory and cardiac arrest and the pupils were dilated. CPR and intermittant static push of 1 mg adrenaline were immediately carried. After endotracheal intubation, the patient's spontaneous heart rate and pupils recovered, and her blood pressure recovered to 105/53 mm Hg. It was suggested that the patient was suffering from iodixanol-induced anaphylactic shock and nephropathy, and she was transferred to the intensive care unit. Despite immediate treatment, the patient died.
A 47-year-old female patient with no history of allergies developed severe fatal anaphylactic shock after receiving iodixanol. Although contrast agents induced anaphylactoid/anaphylactic reactions do not often occur, clinicians should be conscious of the potentially serious anaphylactic reaction, which could lead to a life-threatening or fatal event.
碘克沙醇引起的过敏反应是造影剂一种众所周知的不良事件，造影剂一般耐受性良好且反应可逆。已有关于计算机断层扫描（CT）增强后出现严重和致命反应如过敏性休克的描述。然而，文献中尚无关于这些事件的数据。
本报告描述了一例可能与碘克沙醇有关的严重过敏反应病例，并对病例报告进行综述。
一名47岁女性，持续腹痛一个多月，两周前经CT检查提示有食管裂孔疝，入住胃肠外科。患者接受腹部CT增强检查以评估多个腹腔内血流动力学特征。腹部增强CT扫描几分钟后，患者面色苍白、出汗、肌肉紧张且颤抖，甚至昏迷，血压极低，为90/43 mmHg。立即给予吸氧支持，皮下注射肾上腺素、静脉注射地塞米松，并快速静脉滴注复方氯化钠。十分钟后，患者呼吸和心跳骤停，瞳孔散大。立即进行心肺复苏并间断静脉推注1 mg肾上腺素。气管插管后，患者自主心率和瞳孔恢复，血压恢复至105/53 mmHg。提示患者发生碘克沙醇所致过敏性休克及肾病，转至重症监护病房。尽管立即进行了治疗，患者仍死亡。
一名无过敏史的47岁女性患者在接受碘克沙醇后发生严重致命性过敏性休克。尽管造影剂引起的类过敏/过敏反应不常发生，但临床医生应意识到潜在的严重过敏反应，其可能导致危及生命或致命事件。
