Severe liver and renal injuries following cerebral angiography: late life-threatening complications of non-ionic contrast medium administration

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.

Keywords: Children; Contrast media; Liver; Renal failure.