Immediate Adverse Reactions and Anaphylaxis Associated with Gadolinium-based Contrast Agents in a Patient with Meningioma: Case Report and Literature Review

Abstract

Object: Gadolinium chelates are relatively safe contrast media used in MRI. Immediate severe adverse effects are exceptionally rare.The incidence of immediate hypersensitivity reactions to MR contrast media was 0.079%, and the recurrence rate of hypersensitivity reactions was 30% in patients with previous reactions. The risk factors for immediate hypersensitivity reactions to MR contrast media were the female sex, allergies and asthma. Case: We report a case of anaphylactic shock due to Gadobenate dimeglumine. While undergoing a magnetic resonance imaging examination, 36 year-old female patient became severely hypotensive, lost consciousness, and had generalized erythema immediately after the intravenous injection of this product. She recovered rapidly after injection of epinephrine and her blood volume was restored with intravenous fluids.  Conclusions: Although gadolinium is a safe contrast medium, anaphylactoid reactions do occur. Some are severe. Reactions to MR imaging contrast media are uncommon enough that radiologists may not be as familiar with their management as they are with the treatment of complications associated with iodinated radiographic contrast media. Gadobenate dimeglumine is comparable to gadodiamide in terms of safety and efficacy for imaging of CNS lesions.