Korean J Crit Care Med.  2012 Aug;27(3):187-190. 10.4266/kjccm.2012.27.3.187.

A Case of Anaphylactoid Reaction to Gadolinium Contrast Media and Propranolol Complicated with Acute Respiratory Distress Syndrome (ARDS): A Case Report

• Kim JH
• Kim KH
• Jeong HC
• Kim EK
• Lee JH

• KMID: 2227968
• DOI: http://doi.org/10.4266/kjccm.2012.27.3.187

Abstract

Anaphylaxis/anaphylactoid reaction is a medical emergency. In rare cases, acute respiratory distress syndrome (ARDS) can complicate this disorder. This is a case report of an anaphylactoid reaction complicated with ARDS that was successfully treated using extracorporeal membrane oxygenation (ECMO). A 52-year-old female patient developed sudden dyspnea immediately after she received gadolinium contrast injection and 80 mg of oral propranolol. She progressed rapidly to a state of shock and her chest radiograph showed pulmonary edema. The shock and pulmonary edema did not respond to epinephrine or steroid injection. On the next day, the permeability edema worsened and laboratory test revealed extreme hemoconcentration. The oxygenation goal was not achieved with mechanical ventilation alone, thus ECMO was applied as well. The patient showed clinical improvements on the 3rd day and was weaned from ECMO on the 4th day. She was completely recovered from shock and respiratory distress by day 5. The patient was discharged from hospital without further complications.

Keyword

anaphylaxis; respiratory distress syndrome; extracorporeal membrane oxygenation; gadolinium; propranolol

MeSH Terms

Anaphylaxis
Contrast Media
Dyspnea
Edema
Emergencies
Epinephrine
Extracorporeal Membrane Oxygenation
Female
Gadolinium
Humans
Middle Aged
Oxygen
Permeability
Propranolol
Pulmonary Edema
Respiration, Artificial
Respiratory Distress Syndrome, Adult
Shock
Thorax
Contrast Media
Epinephrine
Gadolinium
Oxygen
Propranolol