Newer iodine-containing contrast agents safe for children

Allergic-like reactions to newer iodine-containing contrast agents (nonionic contrast media), are rare in children according to a recent study conducted by researchers from the University of Michigan Medical Center and C.S. Mott Children's Hospital both in Ann Arbor.

"A major, if not the main, risk associated with iodine-containing contrast agents is allergic types of reactions. Such reactions can be mild; for example, hives or severe such as difficulty breathing or even cardiopulmonary arrest," said Jonathan R. Dillman, MD, lead author of the study.

"Over the past 20 years, we have changed the type of iodine-containing intravenous contrast agents used primarily for computed tomography (CT) and intravenous pyelogram (IVP) examinations in both adult and pediatric patients. The nonionic contrast media that we now use have been studied extensively in adults, but not as much in children. We performed our study because we wanted to find out what the exact risk of allergic reactions to these newer contrast agents was in children," said Dr. Dillman.

The study evaluated 11,306 pediatric IV administrations of iodine-containing contrast agents over a seven year period. According to the study, acute allergic-like reactions were documented in 20 of the patients. Of these patients, 16 of the allergic-like reactions were categorized as mild, one as moderate, and three as severe. Six of the reacting patients had a history of allergic-like reactions, including two patients who had a history of reactions to iodinated contrast material. Five of the patients had a history of asthma.

"While we have long assumed that newer nonionic contrast agents are safe, this study re-affirms their safety and better determines what the risks actually are in children," said Richard H. Cohan, MD, co-author of the study. "Our study confirms that doctors and parents alike can feel comfortable administering these agents to children," he said.

The full results of this study appear in the June issue of the American Journal of Roentgenology, published by the American Roentgen Ray Society.

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