Increased Susceptibility for Adverse Reactions to Ultrasound Enhancing Agents in Sickle Cell Disease

Safety of Ultrasound Contrast Agents in Pediatric Patients With Sickle Cell Disease and Trait

“…Recently, three reports observed an unexpectedly high rate of pain-related adverse events in adults with sickle cell disease following IV administration of the UCA Definity. [16][17][18] Back pain was the most commonly reported symptom in these studies, with additional reports of hip pain, chest pain, diffuse pain, and headache. In one study, it was theorized that phospholipid components in the shell of Definity may trigger molecular pathways similar to those involved in vaso-occlusion, thus leading to pain.…”

“…Our study was performed in light of three recent reports that described a potential for more frequent pain-related adverse events with the intravenous administration of Definity in adult patients with sickle cell disease. [16][17][18] The first study that reported painrelated adverse events with Definity included 32 adults with sickle cell disease who underwent IV CEUS for quantification of muscle perfusion. 16 In this study, a higher than expected rate of pain episodes was observed among the first 17 study participants who underwent IV CEUS exams with Definity.…”

“…Aiming to identify a potential mechanism based on the pathophysiologic pathways involved in vasoocclusive episodes, a recent comprehensive study combined clinical safety data, biochemical markers, and experimental animal data. 18 Safety data were obtained from two prospective clinical trials including 55 patients with sickle cell disease who underwent IV CEUS for muscle perfusion and echocardiography with high dose of Definity infusion. Blood samples from the participants in these trials were analyzed before and after administration of Definity to measure plasma concentrations of complement proteins, phospholipids, and lysophospholipids.…”

“…Recently, three reports observed an unexpectedly high rate of pain‐related adverse events in adults with sickle cell disease following IV administration of the UCA Definity 16–18 . Back pain was the most commonly reported symptom in these studies, with additional reports of hip pain, chest pain, diffuse pain, and headache.…”