Anyone else have allergic reaction to scan contrast dye?

[Vicky]

Hi everyone,

I am being scheduled for my next set of scans in the the next couple of weeks and was wondering if anyone else has ever reacted to contrast dye and what was done for it? I had an immediate reaction two scans ago- racing heart, throat going closed and broke out in hives. So we tried benadryl, and dexamethasone for the next set of scans. Delayed hives and rash with rapid heartbeat for hours afterwards.

So now instead of a CT scan, I am having 2 MRI's- one brain, one pelvis, abdomen and chest, and 1 CT scan without contrast. I am on tdm1 and the trial is dictating what scans I need.

The tricky part for me is that my yearly benefit allowance for scans is capped at 3,000 dollars. I can't possibly pay for 3 sets of scans every 9 weeks... anyone have any ideas?

[Ellie F]

Hi Vicky
Just wondering if there is only ONE type of contrast available for ct scans in the States? For many other procedures there are a number of similar products that do the same job but may not cause the same reaction. Would your radiologist be able to research this for you? The reason I ask is that I have had ct scans at two different hospitals here in England but both used different contrast.
Hope this helps, I know some things are done differently across the pond.
Ellie

[Sheila]

Vicky
What about a PET/CT which uses a different type of tracer injection....more expensive than a regular CT, but maybe cheaper and easier on you in the long run...I would ask.....

[Vicky]

Thank you Ellie, thank you Sheila, I have chemo and onc visit tomorrow and will bring up both of your ideas. I knew someone here would be able to think of something I hadn't! I am convinced there is an alternative out there that I just haven't uncovered yet.

[ElaineM]

I am like you. I had a very bad reaction the first time I ever had a cat (ct) scan. It was very scary. That sure created alot of action in the cat scan dept too !! People came running from everywhere to help. They kept me at the hospital for several hours to make sure I recovered before they let me go home.
I am allergic to the iodine in the cat scan injection. The next time I had a cat scan they gave me predisone pills and benadryl pills. I had to start the predisone the night before and take the benedryl about an hour before the scan.
After that they switched me from plain cat scans to pet/ct scans that do not require the same contrast injection. I also did not require the extra medicines. In addition to a contrast injection that does not create problems I got two tests for the price of one. (Pet and Cat).
You can also try an MRI. They require a contrast injection, but the injection does not contain iodine.
I wonder if ultra sounds would give enough information for you and your doctors? They do not require any contrast injections. They can be done on most parts of the body from the chest to the pelvis.
Also there is another kind of Cat scan contrast injection without iodine, but I don't remember the name. Ask your doctor or the cat scan dept for more information. They might also be willing to do the cat scan without the contrast injection sometimes. We tried that once. The pictures came out clear enough to see. I guess that depends on the quality of the cat scan machine or the radiologists actually doing the test. 64 slice cat scan machines give better pictures than older machines do.
The best of luck with T DM1. I am happy you are able to get it now.

[PinkGirl]

I don't think the same contrast is used for CT's and MRI's. I am okay with the CT contrast but I have had a reaction to the MRI contrast. I take benydryl before an MRI and have to hang around afterwards to watch for hives.

[Rich66]

Although my mom has had to go to non contrast CTs, I remember premeds more like:
http://svhrad.com/svhrad2/index.php?option=com_content&task=view&id=123&Itemid=306

Dex seems more typically used with chemos, not as a scan premed.

This guideline has premed discussion info on page 5, specifics page 8:

http://www.acr.org/SecondaryMainMenuCategories/quality_safety/contrast_manual/FullManual.aspx


Premedication Strategies
Oral administration of steroids is preferable to IV
administration, and prednisone and methylprednisolone are equally effective. It is preferred that steroids be given beginning at least 6 hours prior to the injection of contrast media regardless of the route of steroid administration whenever possible. It is unclear if administration for 3 hours or fewer prior to contrast reduces adverse reactions.


Two frequently used regimens are:
1. Prednisone: 50 mg by mouth at 13 hours,
7 hours, and 1 hour before contrast media
injection, plus
Diphenhydramine (Benadryl®): 50 mg intravenously,
intramuscularly, or by mouth 1 hour
before contrast medium [12]
or
2. Methylprednisolone (Medrol®): 32 mg by
mouth 12 hours and 2 hours before contrast
media injection. An anti-histamine (as in
option 1) can also be added to this regimen
injection [34]. If the patient is unable to take
oral medication, 200 mg of hydrocortisone
intravenously may be substituted for oral
prednisone in the Greenberger protocol.

Emergency Premedication
(In Decreasing Order of Desirability)
1. Methylprednisolone sodium succinate (Solu-
Medrol®) 40 mg or hydrocortisone sodium
succinate (Solu-Cortef®) 200 mg intravenously
every 4 hours (q4h) until contrast study
required plus diphenhydramine 50 mg IV 1
hour prior to contrast injection [35].
2. Dexamethasone sodium sulfate (Decadron®)
7.5 mg or betamethasone 6.0 mg intravenously
q4h until contrast study must be done in patent
with known allergy to methylprednisolone, aspirin,
or non-steroidal anti-inflammatory drugs,
especially if asthmatic. Also diphenhydramine
50 mg IV 1 hour prior to contrast injection.
3. Omit steroids entirely and give diphenhydramine
50 mg IV.
Note: IV steroids have not been shown to be
effective when administered less than 4 to 6
hours prior to contrast injection.
Changing the Contrast Agent to be Injected
In patients who have a prior, documented contrast
reaction, the use of a different contrast agent, has
been advocated and may sometimes be protective
[36]. However, a change from one to another lowosmolality agent generally appears to provide little or no benefit [37]. An optional switch to a different agent may be combined with a pre-medication regimen.


A large nonrandomized nonblinded study suggests significantly greater safety of nonionic contrast agents [1]. Similar safety margins have been claimed in other nonrandomized trials [21]; however, no definitive unbiased randomized clinical trials exist that demonstrate significant reduction in severe reactions and fatality [21]. Low-osmolality contrast agents also reduce the non-idiosyncratic physiologic reactions that are not related to allergy. For these reasons there is general agreement that the safety margin for low osmolality contrast agents is better than that for ionic high-osmolality agents

[Vicky]

@Elaine,

Yes, my onc agreed that a non contrast CT scan was the way to go. Along with a series of MRI's as I don't react to that contrast at all. Thank you for your support and encouragement- I feel very fortunate to be on TDM1- round 15 today!

@pinkgirl MRI's go fine for me- other than I require sedation so I can go in the tube, but that is easy compared to worrying about reacting to dye :)

@Rich- yes, dex was prescribed at an earlier time to go with chemo when it was thought I was stage III. So I used that instead of asking for prednisone. Thanks for the quotes, its exactly what I have been searching for and am happy you put me in touch with them. Prednisone and Benadryl may be what we will end up with if we can't get a clear look from the CT scan without contrast. Thanks so much!

[chrisy]

Vicki, taking a different tack here...

Surprisingly I no very little about the contrast dye considering how many scans ive had! I do know MRI uses different contrast than ct

But, having been on tdm1 trials that dictated what scans were required, a couple of times my insurance denied the Pre-auth and the trial sponsor covered the cost.

Good luck with your scans, whatever they end up being!

[SoCalGal]

I am also allergic to the ct scan dye. I just don't use the contrast. They can see plenty this way. I also do a petsscan for the body and an MRI for the head. Good luck!

[Vicky]

Thanks Chrisy! My research nurse said she will look into this for me- since the trial denied the use of a PET scan- hopefully they will help cover the costs of all the scans I will need.

SoCalGal, I hope the radiologist in my case will see things clearly too and then scans would become a piece of cake! Thanks for the input!