Rare case of pulmonary edema reported with MRI contrast agent

In this case, rapid development of dyspnea and cyanosis immediately after administration of i.v. gadobutrol suggests NCPE (Noncardiogenic pulmonary edema). Rales were present in the lungs, the PaO2/FiO2 rate was less than 200, there was increased pulmonary vascular congestion on chest X-ray, and there was rapid response to treatment; all supporting NCPE. Gadobutrol associated skin lesions have rarely been reported. In our patient, excessive hypotension, despite the lack of skin lesions, suggests severe anaphylactic reaction. The patients' diagnosis was anaphylactic shock with noncardiogenic pulmonary edema and provides the first case in the current literature.

"Anaphylactic shock with noncardiogenic pulmonary edema after the use of gadobutrol is presented in this paper. As this is the first case in the literature, we suggest anaphylactic shock and noncardiogenic pulmonary edema must be kept in mind during MRI. Additionally, as in this case, accompanied hypopotassemia requires analysis and should be investigated in terms of gadobutrol attributable arrests, and, in particular, hERG mediated potassium current inhibition," concluded the authors. 

"Magnetic resonance imaging contrast agent related pulmonary edema: a case report," is published in the journal European Review for Medical and Pharmacological Sciences.