Acute renal failure following intravenous pyelography (IVP) in a patient with diffuse hypergammaglobulinemia: A case report

Antman, Karen H.; Parker, Leroy M.; Goldstein, Jeffrey; Skarin, Arthur T.; D’Orsi, Carl J.

doi:10.1002/mpo.2950100310

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…Cardiac angiography and intravenous urog raphy also result in significant adverse reactions. 12,14,16,17,29,65,72,73,93,128,155,156,183 The other proce dures result in relatively milder and less frequent adverse reactions. 12,19,30,31,35,38,51,100,132,165,175,189 Undoubtedly the pathophysiology of these contrast media-induced reactions are complex and may not be related to a single pathway.…”

Section: Fig 23 Reactions To Contrast Media and Their Manage Mentmentioning

confidence: 99%

Molecular Markers of Contrast Media-Induced Adverse Reactions

Fareed¹,

Moncada²,

Messmore³

et al. 1984

Semin Thromb Hemost

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Currently used routine laboratory screening methods are not reliable in the prediction of contrast media-related adverse reactions. Cost-effective laboratory methods for various molecular markers of pathophysiologic activation have now become available. In vitro activation tests in high-risk patients may prove to be useful in the prediction of contrast-induced activation of various adverse reactions. If prior clinical evaluation of a patient suggests an ongoing pathologic process, profiling of the following molecular markers may prove to be useful and helpful in avoiding contrast-induced adverse reactions: Fibrinopeptide A, platelet factor 4, thromboxane B2, 5-HETE, physiologic inhibitors of proteases, B beta 15-42 related peptides, bradykinin/kininogen, and anaphylactozins. In patients suspected of reacting to contrast agents, a small dose of 1 to 5 ml can be injected as a bolus and molecular marker profiling on blood drawn after the infusion may prove to be useful screening tests. Additional clinical studies are needed to prove this. However, this screening test should be performed with extreme caution, since some of the patients are known to react to as little as 1 ml dose. The safety of newly developed nonionic contrast agents can be readily assessed by profiling various molecular markers of adverse reactions, which provide a more reliable and quantitative assessment of contrast-induced adverse reactions. Based on molecular marker profiling, various prophylactic agents can be given to high-risk patients to avoid contrast-induced adverse reactions.

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