Anaphylactoid reactions to radiocontrast material

Lieberman, Phil

doi:10.1007/bf02802311

Cited by 21 publications

(2 citation statements)

References 121 publications

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“…70 While some studies (in vitro and in vivo) and a case report found consumption of complement after contrast media administration, 31,[71][72][73][74] others failed to describe any changes in complement factors. 75,76 Complement activation through contrast media in particular has been identified (1) by activation via both the classic and alternative pathway, 77,78 (2) nonspecific, consequential cleavage of complement proteins, 79 (3) suppression of complement inhibitors factor H and I, 77 and (4) direct activation of C3 and C4. 80 However, with regard to the occurrence of DIC in anaphylaxis irrespective of the triggering agent, the link between complement and coagulation has been well established.…”

Section: Complement-coagulation Crosslinkmentioning

confidence: 99%

“…Complement activation through contrast media in particular has been identified (1) by activation via both the classic and alternative pathway, 77 78 (2) nonspecific, consequential cleavage of complement proteins, 79 (3) suppression of complement inhibitors factor H and I, 77 and (4) direct activation of C3 and C4. 80…”

Section: Interplay Of Anaphylaxis and Disseminated Intravascular Coag...mentioning

confidence: 99%

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Disseminated Intravascular Coagulation in Anaphylaxis

Gelbenegger,

Buchtele,

Schoergenhofer

et al. 2023

Semin Thromb Hemost

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Anaphylaxis is a life-threatening condition that involves severe cutaneous, respiratory, and cardiovascular symptoms. Disseminated intravascular coagulation (DIC) is an acquired, widespread activation of coagulation that can be caused by infectious conditions (e.g., sepsis) and noninfectious conditions. The onset of DIC following anaphylaxis is not commonly known, and information regarding the pathomechanism linking anaphylaxis to DIC is scarce. Further, demographic and clinical data in anaphylaxis-induced DIC are still missing to this day. Triggered by a case of anaphylaxis-induced DIC that seamlessly transitioned to lethal sepsis-induced DIC, we aimed to characterize the patient population affected by anaphylaxis-induced DIC by performing a review of existing literature and expand the discussion to underlying mechanisms. The overall mortality of the patient cohort (n = 30) identified by the literature review was 50%. All patients that died either suffered a bleeding event or a thrombotic event. The majority of patients (n = 25/30; 83%) had bleeding events; thrombotic events were only reported in nonsurvivors (n = 9/15 or 60% of nonsurvivors; vs. n = 0/15 in survivors; p < 0.001). Nonsurvivors of anaphylaxis-induced DIC were on average 25 years older than survivors (p = 0.068). In conclusion, DIC can complicate anaphylaxis and is expected to contribute to poor microvascular perfusion after anaphylaxis. Particularly, elderly patients with known cardiovascular disease and patients who develop thrombotic events are susceptible to lethal outcomes. As a rare and largely uncharacterized disease entity, further research is needed to investigate the link between DIC and anaphylaxis and to potentially identify better treatment strategies.

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Section: Complement-coagulation Crosslinkmentioning

confidence: 99%

Section: Interplay Of Anaphylaxis and Disseminated Intravascular Coag...mentioning

confidence: 99%

Disseminated Intravascular Coagulation in Anaphylaxis

Gelbenegger,

Buchtele,

Schoergenhofer

et al. 2023

Semin Thromb Hemost

View full text Add to dashboard Cite

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Elevated Risk of Anaphylactoid Reaction From Radiographic Contrast Media Is Associated With Both ß-Blocker Exposure and Cardiovascular Disorders

Lang

Alpern²,

Visintainer³

et al. 1993

Arch Intern Med

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beta-Blocker exposure and cardiovascular disorder are both statistically significant risk factors for severe anaphylactoid reaction from contrast media. Thus, patients receiving beta-adrenergic blockers and patients with asthma, on the basis of greater risk for bronchospasm, and patients with cardiovascular disorders, on the basis of elevated risk of major and life-threatening reaction, are appropriate target populations for risk reduction measures before receiving intravenous infusion of contrast media.

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Allergic Reactions to Drugs and Biologic Agents

deShazo¹

1997

JAMA

181

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Drug allergies are adverse reactions resulting from immunologic responses to drugs or their metabolites. These reactions result in predictable patterns of organ-specific or systemic hypersensitivity that usually recur on subsequent exposure to the same drug. Although diagnostic testing for drug allergy is available for only a few drugs, protocols have been developed to assist in management of allergic reactions to many drugs and biologic agents. Other protocols assist in the management of patients who develop drug reactions while undergoing multiple drug therapy or those with a history of adverse drug reactions who again require treatment for the same condition.

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Anaphylactoid reactions to radiocontrast material

Cited by 21 publications

References 121 publications

Disseminated Intravascular Coagulation in Anaphylaxis

Disseminated Intravascular Coagulation in Anaphylaxis

Elevated Risk of Anaphylactoid Reaction From Radiographic Contrast Media Is Associated With Both ß-Blocker Exposure and Cardiovascular Disorders

Allergic Reactions to Drugs and Biologic Agents

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