Radiocontrast Media

During the radiologic evaluation of patients, various types of low-molecular-mass, water-soluble, radiocontrast media are administered to patients via the intravenous route. Rashes, urticaria, angioneurotic edema, and smooth muscle spasms occur with some frequency. Occasionally, patients develop hypotension, pulmonary edema, and cardiac arrest as a result of an anaphylaxis-type reaction. Mortality from radiocontrast media administration is 1-5/100,000 (Moreau et al., 1988).

Radiocontrast media may act directly on mast cells and basophils to release mediators. Salts of ioxaglic acid, ioxithalamic acid, and ioversol release preformed mediators such as histamine and trypase. But they do not initiate the de novo synthesis of prostaglandins and leukotrienes (A. Genovese et al., 1996). The effect differs with the nature of the target cell (mast cells or basophils) and the anatomic site. Hyperosmolality may play an important role in the activation of basophils but not mast cells (Stellato et al., 1996).

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