UKRG Handbook ADVERSE REACTIONS AND DEFECTIVE RADIOPHARMACEUTICALS
This section contains a summary of the 1999 collation of reports from the EANM Committee on Radiopharmaceuticals originally published in the European Journal of Nuclear Medicine (2001) 28: BP2-BP8.
ADVERSE REACTIONS
Adverse reactions to radiopharmaceuticals are uncommon, unusually
transient and minor in severity. Nevertheless familiarity with the type of reaction
observed allows the observer to recognise such events when they do occur
Radiopharmaceuticals reported to have caused adverse reactions
|
Radiopharmaceutical |
Number of reports |
Symptoms described
|
| Diphosphonates |
13
|
Rash on neck, arms, chest, developing 2-24 h after injection; Urticaria affecting upper arms, chest; Dry mouth, swollen sore lips; Oedema of face and eyes; Dizziness, sweating; Headache, lethargy; Nausea and Vomiting |
| MAG-3 |
4
|
Rash covering whole body; Urticaria affecting neck 3-4 h after injection; Violent coughing 2 min after injection |
| DMSA |
7
|
Progressive rash covering body; Onset of rash within minutes to 6 h after injection; Headache, tiredness, puffy eyes; Changes in breathing pattern 30 s after injection in 3-month-old child, with blotches appearibg on skin |
| DTPA |
4
|
Rash all over body within 1 h; Rash on forearms and hands within 30 min; Profuse sweating, fall in BP immediately after injection; numbness of neck and face |
| MAA |
1
|
Rash immediately after injection |
| Sestamibi |
5
|
Urticaria rash within 2-3 h; Fleeting metallic taste; Violent coughing, nausea, retching 20 min after injection; Malaise, fever, pruritis, nausea 8 h post injection |
| Iodine-131 iodocholesterol |
1
|
Pain during injection, taste of strawberries |
| Exametazime labelled leucocytes |
1
|
Reddening and puffiness of face immediately after injection |
| Chromium EDTA |
2
|
Itchy, erythematous rash on chest, upper back and neck |
| Iodine-123 iodide |
1
|
Swelling of forearm and fingers; Tenderness in wrist |
The 39 reports arose from 10 different radiopharmaceuticals. The majority of reports were minor and resolved quickly without the need for treatment, other than patient reassurance and care. Where treatment was given, this was symptomatic and commonly involved antihistamine and/or steroid administration. Diphosphonates continue to produce most reports, reflecting the widespread use of these radiopharmaceuticals. There were seven probable reactions to DMSA, six of which occured in children. This again reflects the prevalence of use of this radiopharmaceutical in paediatric patients. It is also possible that departments are more likely to be made aware of and report reactions in children.
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