Intravenous radiocontrast induced anaphylactoid reaction: a rare cause of death

Summary

Anaphylactoid reaction after the injection of iodinated contrast media can be life threatening. A 23-year-old woman presented to the emergency room with abdominal pain and fever, for couple of days duration. After completion of a computed tomography (CT) scan of the abdomen and pelvis with intravenous contrast, the patient complained of feeling hot and shortness of breath. She became unresponsive, cyanotic, and developed asystole. The patient was successfully intubated without any laryngeal oedema or bronchial spasm. Despite all resuscitation efforts the patient died. The patient had undergone CT scans with contrast three times in the past. An autopsy could not reveal any obvious cause and the serum tryptase concentration was 211 ng/ml (normal <9 ng/ml).