Borish L, Matloff S M, Findlay S R
J Allergy Clin Immunol. 1984 Jul;74(1):104-7. doi: 10.1016/0091-6749(84)90095-2.
Adverse reactions are a frequent complication of exposure to radiographic contrast media (RCM). These reactions are most often anaphylactoid in nature and are characterized by the occurrence of urticaria, angioedema, bronchospasm, and shock. In patients who have had an anaphylactoid reaction to RCM and in whom reexposure is indicated, various pretreatment protocols have been developed to mitigate the risk for recurrence. We report the case of a 46-year-old man who, while undergoing cardiac catheterization, developed noncardiogenic pulmonary edema. This is the first reported case of the occurrence of noncardiogenic pulmonary edema secondary to RCM documented with Swan-Ganz data. In addition, our patient developed noncardiogenic pulmonary edema despite pretreatment with prednisone and diphenhydramine, administered because of a past history of a similar reaction. Potential mechanisms for such a reaction are discussed.
不良反应是接触放射造影剂（RCM）常见的并发症。这些反应本质上大多为类过敏反应，其特征是出现荨麻疹、血管性水肿、支气管痉挛和休克。对于曾对RCM发生类过敏反应且需要再次接触造影剂的患者，已制定了各种预处理方案以降低复发风险。我们报告了一名46岁男性的病例，该患者在进行心导管插入术时发生了非心源性肺水肿。这是首例经 Swan-Ganz 数据记录的由RCM继发非心源性肺水肿的病例报告。此外，尽管该患者因既往有类似反应史而预先使用了泼尼松和苯海拉明进行预处理，但仍发生了非心源性肺水肿。本文讨论了此类反应的潜在机制。
