Paulo Sergio Lucas da Silva1,2, Emerson Yukio Kubo3, Marcelo Cunio Machado Fonseca4. 1. Pediatric Intensive Care Unit, Hospital Estadual de Diadema, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. psls.nat@terra.com.br. 2. Pediatric Intensive Care Unit, Rua José Bonifácio 1641, Diadema, São Paulo, Brazil, 099800-150. psls.nat@terra.com.br. 3. Pediatric Intensive Care Unit, Hospital Estadual de Diadema, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. 4. Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Abstract
INTRODUCTION: Contrast-induced nephropathy requiring dialysis support is rarely reported, whereas severe liver injury after contrast agent administration has not been described in children yet. CLINICAL CASE: A previously healthy 10-year-old boy with diagnosis of cerebral arteriovenous malformation underwent a cerebral angiogram study with iohexol (3 mL/kg). After 4 days, he developed vomiting and abdominal pain. Laboratory results showed abnormal liver function tests, including marked elevation of transaminases. In the next day, he evolved with oliguria and blood arterial hypertension. At this time, he presented with worsening renal function tests. Peritoneal dialysis was required for 13 days. The patient had a self-limiting course and received only supportive treatment. CLINICAL PRESENTATION: This report highlights delayed complications related to low non-ionic contrast media with a rare presentation that can be neglected or unrecognized by pediatric specialties.
INTRODUCTION: Contrast-induced nephropathy requiring dialysis support is rarely reported, whereas severe liver injury after contrast agent administration has not been described in children yet. CLINICAL CASE: A previously healthy 10-year-old boy with diagnosis of cerebral arteriovenous malformation underwent a cerebral angiogram study with iohexol (3 mL/kg). After 4 days, he developed vomiting and abdominal pain. Laboratory results showed abnormal liver function tests, including marked elevation of transaminases. In the next day, he evolved with oliguria and blood arterial hypertension. At this time, he presented with worsening renal function tests. Peritoneal dialysis was required for 13 days. The patient had a self-limiting course and received only supportive treatment. CLINICAL PRESENTATION: This report highlights delayed complications related to low non-ionic contrast media with a rare presentation that can be neglected or unrecognized by pediatric specialties.
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