Risk factors for an adverse reaction to radiocontrast media:
(1) cerebral or renal disease in patients > 50 years of age
(2) dehydration
(3) history of allergy, including asthma, hay fever, eczema or hives
(4) history of cardiac disease
(5) history of a previous reaction to contrast material
(6) concurrent disease
(6a) multiple myeloma
(6b) homocystinuria
(6c) sickle cell anemia
(6d) pheochromocytoma
(6e) thyrotoxicosis
(6f) hypercoagulability
(7) previous study in which a large dose (> 20 g) of contrast material was used
Management of patients at risk for an adverse reaction to contrast material may include:
(1) use of a low osmolality contrast material rather than a high osmolality material
(2) pretreatment with corticosteroids and antihistamines if an allergic reaction is suspected
(3) re-evaluation of the risk-to-benefit of the procedure, with informed consent
(4) consideration of alternative imaging strategies
