Elevation of serum lactate dehydrogenase-5 following methylglucamine iodipamide (Cholografin/Biligrafin) infusion for intravenous cholangiography.

Methylglucamine iodipamide (Cholografin-North America; Biligrafin-Europe, Squibb) is the only contrast medium in clinical usage for opacification of the biliary tree in intravenous cholangiography. We report two cases of elevation of serum lactate dehydrogenase-5 activity following infusion of 40 ml of Cholografin. This occurred without overt clinical signs of adverse reaction to contrast medium. This elevation was 65% of serum LD-5 activity in case one, 91% in case two. The elevation peaked at 12 h after administration of contrast medium in both cases and persisted for at least 24 h. These findings suggest that methylglucamine iodipamide causes transient hepatocellular toxicity, the mechanism of which is not known.