If the Patient Had a Prior Reaction to a Contrast Agent, Should I Ignore It, Begin a Pre-Treatment Regimen, or Avoid Any Further Contrast Agent Injection?
There is no simple answer. Many different approaches have been suggested. It is not necessary to avoid any further contrast agent injection in most cases. A very small number of patients, anecdotally, have recurrent reactions, which seem to occur after various types of contrast agents and which are not preventable with a pre-treatment regimen. In most cases, these adverse effects are delayed cutaneous reactions (discussed later) that may be severe but are not life threatening. Very rarely, recurrent life-threatening reactions are reported to occur, but these cases are both rare and poorly documented. Use of a different contrast agent is a reasonable approach, although it is often impossible to define either the specifics of a prior reaction or the specific contrast agent used. Obtaining a careful patient history is helpful in this regard. If the patient s reaction occurred in the United States before 1985, a nonionic, low-osmolality agent could not have been used, so one could be used
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