Adverse Reactions to Intravascular Administration of Contrast Media

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Abstract
Adverse reactions [in humans] to intravascular administration of contrast media, while low in incidence, merit serious consideration in view of increased utilization of these substances. Evidence for involvement of soluble mediators, antibody-antigen reactions, psychogenic factors and acute activation systems is reviewed. As a group the pre-contrast challenge plasmas of reactors are characterized by slightly diminished concentrations of C.hivin.1[activated component of complement 1]-esterase inhibitor and total hemolytic complement, and by an accelerated rate of conversion of pre-kallikrein to kallikrein on exposure to contact activators. The role of i.v. pretesting and pretreatment is considered. A rationale for pretreatment with adrenocorticosteroids is presented.