Iodixanol-induced acute kidney injury and multi-organ complications via alternative excretion: A case report and mechanism exploration.

IF 0.9 4区医学 Q4 PHARMACOLOGY & PHARMACY

International journal of clinical pharmacology and therapeutics Pub Date : 2026-06-01 DOI:10.5414/CP204941

Le Li, Lifang Yang, Huifeng Wu, Lin Chen, Zhouqian Jiang

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引用次数: 0

Abstract

Objective: To report a rare case of vicarious contrast material excretion (VCME) following iodixanol administration, leading to acute kidney injury (AKI) and multi-organ complications, and to explore the underlying mechanisms.

Case presentation: A 71-year-old female underwent lower limb venography with intravenous iodixanol. Post-procedure, she developed AKI, followed by acute pancreatitis, hepatic hemorrhage, and hemoperitoneum. Imaging revealed contrast accumulation in the gallbladder and biliary tract, consistent with VCME.

Intervention and outcome: The patient was managed with hemodialysis, octreotide, transfusion, and supportive care. Laboratory and imaging improvements were observed by day 22, with successful discharge.

Conclusion: This case highlights the potential for iodixanol to induce VCME and subsequent multi-organ injury in the setting of AKI. Enhanced preoperative risk assessment, postoperative monitoring, and multidisciplinary management are essential for mitigating such rare but severe complications.

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碘沙醇经选择性排泄致急性肾损伤及多器官并发症1例报告及机制探讨。

目的：报道一例罕见的碘沙醇致急性肾损伤（AKI）并发多器官并发症的静脉造影剂排泄（VCME）病例，并探讨其发生机制。病例介绍：一位71岁的女性接受了静脉注射碘沙醇的下肢静脉造影。术后，患者出现急性胰腺炎、肝出血和腹膜出血。影像显示对比剂在胆囊和胆道积聚，与VCME一致。干预和结果：患者接受了血液透析、奥曲肽、输血和支持性治疗。第22天观察到实验室和影像学改善，并成功出院。结论：本病例强调了碘沙醇在AKI背景下诱导VCME和随后的多器官损伤的可能性。加强术前风险评估、术后监测和多学科管理对于减轻此类罕见但严重的并发症至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of clinical pharmacology and therapeutics 医学-药学

CiteScore

1.70

自引率

12.50%

发文量

116

审稿时长

4-8 weeks

期刊介绍： The International Journal of Clinical Pharmacology and Therapeutics appears monthly and publishes manuscripts containing original material with emphasis on the following topics: Clinical trials, Pharmacoepidemiology - Pharmacovigilance, Pharmacodynamics, Drug disposition and Pharmacokinetics, Quality assurance, Pharmacogenetics, Biotechnological drugs such as cytokines and recombinant antibiotics. Case reports on adverse reactions are also of interest.