The frequency of Adverse Reactions Gadolinium-Based Contrast Media

The frequency of all acute adverse events after an injection of 0.1 or 0.2 mmol/kg of gadolinium chelate ranges from 0.07% to 2.4%. The vast majority of these reactions are mild, including coldness at the injection site, nausea with or without vomiting, headache, warmth or pain at the injection site, paresthesias, dizziness, and itching. Reactions resembling an “allergic” response are very unusual and vary in frequency from 0.004% to 0.7%. A rash hives, or urticaria are the most frequent of this group, and very rarely there may be bronchospasm. Severe, life-threatening anaphylactoid or nonallergic anaphylactic reactions are exceedingly rare (0.001% to 0.01%). In an accumulated series of 687,000 doses there were only 5 severe reactions. In another survey based on 20 million administered doses there were 55 cases of severe reactions. Fatal reactions to gadolinium chelate agents occur but are extremely rare.
Gadolinium chelates administered to patients with acute renal failure or severe chronic kidney disease can result in a syndrome of nephrogenic systemic fibrosis (NSF). (See the Chapter on Nephrogenic Systemic Fibrosis – NSF)