A review of adverse reactions to gadolinium contrasts (MRI) in the last 10 years

Adverse reactions associated with the administration of gadolinium contrasts are rare and fortunately serious cases are not common. Sixty patients with adverse reactions to gadolinium contrasts were referred from Magnetic Resonance Department (MRI) to our Allergy Department in the last 10 years. Prick tests with contrasts derived from gadolinium were performed in all cases and if they were negative, intradermal tests were carried out in dilution 10-3 to 10-1. In all patients, a Basophil Activation Test (BAT) was also performed with the contrast involved and other alternative contrasts. In 3 cases the clinical manifestations were severe (anaphylaxis). A positive response was obtained in nine patients and the allergy study was negative in the remaining 51 cases. Only in one case a positivity was observed with the same contrast in skin tests and BAT. The other 8 patients were diagnosed only by a positive BAT. In the 9 cases of allergy, a negative result could be obtained with some alternative contrast. In the 3 cases with a positive allergological study that required a new exploration, it was performed with the contrast whose result was negative by BAT. A good tolerance was obtained under allergological supervision. −Adverse reactions due to gadolinium contrasts are rare but can be serious.−BAT has been more useful than skin tests in our patient series.−The allergological study proves to be useful both to document the reaction and to look for alternatives.