Radiocontrast Agent - Adverse Effects - Anaphylactoid Reactions

Anaphylactoid Reactions

Anaphylactoid reactions occur rarely, but can occur in response to injected as well as oral and rectal contrast and even retrograde pyelography.

They are similar in presentation to anaphylactic reactions, but are not caused by an IgE-mediated immune response. Patients with a history of contrast reactions, however, are at increased risk of anaphylactoid reactions.

Pretreatment with corticosteroids has been shown to decrease the incidence of adverse reactions.

Anaphylactoid reactions range from urticaria and itching, to bronchospasm and facial and laryngeal edema. For simple cases of urticaria and itching, Benadryl (diphenhydramine) oral or IV is appropriate. For more severe reactions, including bronchospasm and facial or neck edema, albuterol inhaler, or subcutaneous or IV epinephrine, plus diphenhydramine may be needed. If respiration is compromised, an airway must be established prior to medical management.

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