Immediate and delayed reactions to contrast media during intravenous urography

ABSTRACT

To highlight the incidence of both immediate and delayed reactions to the intravenous administration of urografin 70% [meglumine and NA diatrizoate] and niopam 300 [iopamidol] for urographic examination. Twelve hundred patients, over 18 years of age, who were referred to the radiology department at Queen Alia Military Hospital for non-emergency of urograph from 1st October 1996 until 30th September 1998 were examined. A specially designed questionnaire investigating reactions or side effects noticed by patients after the injection was distributed. Data were collected and analyzed. A total of 1699 patients received single injections of either urografin or niopam. Eight hundred and forty four patients received urografin 70% and 855 patients received niopam 300. Significant differences were found in the incidence of both types of reactions to the two media with respect to nausea and vomiting, arm pain, and taste in the mouth, which was commoner in patients receiving urografin 70%, whereas the incidence of delayed skin rashes and parotid swelling was commoner with niopam 300. The occurrence of a flu-like illness, so-called "iodism ", was found to be equal in the two contrast media groups. Conclusion:1. Patients seem to prefer non-ionic media, which give them a more comfortable examination. 2. Intermediate and sensitivity reactions are commoner with urografin. 3. Delayed reactions are very common with both types of media, particularly arm pain, a flu-like illness and rashes. Delayed rashes and perhaps parotitis are commoner with non-ionic media. 4. Routine use of non-ionic contrast media for urography does not appear justified