In patients with pheochromocytoma, pretreatment with phentolamine, an a-adrenergic antagonist, is recommended prior to contrast administration. In a nonstabilized patient with recent seizures, pretreatment with diazepam may be advisable.1 Convulsions or seizures following contrast administration may be due to a lowering of the seizure threshold, or they may be a final result of a severe hypotensive or vasovagal reaction. 4
As mentioned above, hyperuricemia and dysproteinemias, such as multiple myeloma, are associated with an increased risk of contrast-induced renal insufficiency, but there is conflicting evidence regarding the strength of this relationship. Similarly, some studies suggest that sickle cell trait and disease are also associated with an increased risk of contrast reaction, but the significance of the relationship is unclear.
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