A case of cardiac arrest and DIC caused by anaphylactic reaction to gadolinium

Abstract

We describe the details of a case of cardiac arrest and fibrinolytic DIC caused by an anaphylactic reaction to a gadolinium-based contrast agent gadobutrol. An otherwise-healthy woman in her 70s underwent contrast-enhanced MRI for a suspected metastatic brain tumor. At 10 min after administration of the gadobutrol, she experienced cardiac arrest due to anaphylactic shock. She was successfully resuscitated within 12 min. After she was transferred to the ICU, multiple hematomas developed at the sites of venous or arterial lines. Laboratory tests revealed fibrinolytic DIC with fibrinogen 71 mg/dL, FDP 491.4 μg/mL, and D-dimer 26.2 μg/mL, all of which resolved spontaneously. MRI contrast agents are considered safer than iodinated contrast media, but if an anaphylactic reaction occurs, it could be fatal within minutes. Anaphylaxis can also cause fibrinolytic DIC. Health care personnel should be aware of these life-threatening potential adverse reactions to MRI contrast agents and treat the affected patients immediately.