Anaphylaxis Induced by Magnetic Resonance Imaging (MRI) Contrast Media

Opinion statementPurpose of reviewThe aim of this document is to review the epidemiology, diagnosis, and treatment of immediate and anaphylactic reactions to gadolinium-based contrast agents (GBCA) most commonly used in magnetic resonance imaging (MRI).Recent findingsThe frequency of adverse reactions to GBCA ranges from 0.04 to 2.2%. Most reactions are mild (47%-95%) and the frequency of anaphylactic shock is 0.004%-0.01%. Mortality due to anaphylaxis induced by GBCAs has been 0.0019%.Allergic reactions are more frequent in patients with a previous reaction, in females, using macrocycle estructure GBCA and with hepatic, abdominal, and thoracic examinations. Determination of tryptase in the acute phase, and allergy study could confirm the culprit drug and assess the use of an alternative GBCA.Allergic reactions, including anaphylaxis, can be resolved with appropriate training, early identification, and suitable equipment, especially in radiology departments.SummaryAnaphylaxis to GBCA is extremely rare. A history of previous reactions to GBCA is the main risk factor for a new reaction. In patients who have previously experienced a reaction, it is recommended to perform an allergological study to establish or rule out allergy to GBCAs and to assess the use of an alternative GBCA if necessary.