Allergic-like reactions to gadolinium-containing contrast injections in adults and pediatric patients (those younger than 19 years of age) are rare, according to a recent study conducted by researchers at the University of Michigan Health Systems in Ann Arbor. "When these reactions do occur, most of them are mild," said Jonathan R. Dillman, MD, lead author of the study.
"Over the past few years, the utilization of contrast-enhanced MRI has markedly increased; it's increased by 65% at our institution over the previous five years," said Dr. Dillman.. This is due, at least in part, to a variety of new applications, such as magnetic resonance angiography (MRA) and abdominopelvic MR imaging," he said. "Consequently, the number of intravenously administered gadolinium-containing contrast material doses over the same time period has significantly increased. Based on the extensive use these intravascular contrast agents, we felt that it was once again time to study their safety profile," he said.
The study included 78,353 gadolinium-containing contrast injections over a five year period. Acute allergic-like reactions occurred following 54 injections. According to the study, 48 reactions involved adults and six occurred in pediatric patients. The study showed that 74% of these reactions were mild, 19% were moderate, and 7% were severe.
"Despite recent concerns that have emerged about the gadolinium-based contrast agents and the development of nephrogenic systemic fibrosis in patients who have severe chronic kidney disease, our study supports the long-held belief that gadolinium based contrast agents can be used safely in both pediatric and adult patients with normal or with only mildly impaired renal function," said Dr. Richard Cohan, co-author of the study. "The risk of allergic-like reactions is exceedingly low (0.07% of administrations in our study), and no fatal reaction occurred at our institution in more than 78,000 intravenous administrations. Patients should feel reassured, based on our results, that the intravenous gadolinium-contrast agents included in our study are quite safe when administered to patients with ample renal function," he said.
The full results of this study appear in the December issue of the American Journal of Roentgenology, published by the American Roentgen Ray Society.