# Skin-Related Adverse Reactions in Gadolinium-Based Contrast Agents-Induced Hypersensitivity: A Systematic Review of the Literature

## TL;DR

This study reviews literature on skin reactions caused by gadolinium-based contrast agents used in MRI scans and finds they are rare and mostly mild.

## Contribution

A systematic review quantifying the low incidence and types of skin-related adverse reactions to GBCAs.

## Key findings

- Skin-related adverse reactions occurred in 0.10% of GBCA administrations.
- Urticaria was the most common reaction (74.7% of reported cases).
- No significant association was found between contrast volume and reaction risk.

## Abstract

Gadolinium-based contrast agents (GBCAs) have been used in clinical settings for several decades and in general they have established a good safety profile. Despite the use of chelating agents, some adverse reactions might occur when using these agents. This review aimed to assess the relationship between administered dose of Gadolinium-based contrast and the rate, duration, and severity of skin-related adverse reactions. Four electronic databases were searched using various relevant keywords. Duplicate records were removed, and the remaining records were retrieved and assessed for eligibility. The inclusion criteria were observational or experimental studies that analyzed the rate of immediate and/or delayed adverse reactions to GBCAs in magnetic resonance imaging. Data were extracted into a pre-designed spreadsheet. Ten studies were deemed eligible to be included in this review. A total of 691,007 GBCAs injections/patients were included in these studies. Six hundred seventy-nine skin-related adverse reactions were reported among the study participants, with a rate of 0.10%, urticaria was the most common (499 cases, 74.7%), while allergic dermatitis (three cases, 0.5%) and angioedema (four cases, 0.6%) were least frequent. In conclusion, the rate of these skin-related adverse reactions was low. The most commonly reported reactions were urticaria, rash, and pruritus. Most of these reported reactions were mild, no significant association was found in the volume of contrast agents and the risk for developing adverse reactions reported in the included studies.