A case of anaphylactoid reaction to nonionic contrast agent, Iodixanol (Visipaque(R)) during coronary angiography / 대한내과학회지

ABSTRACT

Radiocontrast agent infusion is the most common cause of non-IgE mediated anaphylactoid reaction in the modern medical procedures. The newer lower-osmolar nonionic contrast agents cause significantly lower adverse reactions than the high-osmolar ones. However, anaphylactoid reaction to nonionic contrast agent can cause life-threatening events and even death has been rarely reported. Iodixanol (Visipaque(R)) is a nonionic, dimeric contrast agent, which is currently used in cardiac catheterization. Here we report a case of anaphylactoid reaction to Iodixanol, a nonionic radiocontrast agent, during cardiac catheterization. A 45-year-old male patient underwent cardiac catheterization for evaluation of substernal pain during exercise. Five minutes after this contrast injection to the left coronary artery, he complained itching and dizziness. Subsequently, generalized urticaria, cyanosis and hypotension were developed. His coronary angiogram showed normal findings. He was treated with intravenous fluids, intravenous diphenhydramine, sucutaneous epinephrine and sympathomimetics and one hour later he recovered. This case suggests that anaphylactoid reaction to a radiocontrast media, iodixanol, should be considered in the list of differential diagnoses for cardiopulmonary arrest during cardiac catheterization.