PDF(Pubmed)
Abstract：
OBJECTIVE: It is uncertain whether modern iodine-based or gadolinium-based contrast media (CM) administration can lead to increased symptoms in patients with myasthenia gravis.
METHODS: A systematic search in Medline was conducted for studies describing the symptomatology of myasthenia gravis patients before and after receiving intravenous (IV) CM and having a matched control group of myasthenia gravis patients who did not receive IV CM.
RESULTS: Three retrospective studies were selected with a total of 374 myasthenia gravis patients who received iodine-based CM and a total of 313 myasthenia gravis patients who underwent unenhanced CT and served as controls. Pooling of the data from the three retrospective studies showed that in 23 of 374 patients, increased symptoms after iodine-based CM administration were described (6.1%). Increased symptomatology also occurred in 11 of 313 patients after unenhanced CT (3.5%). When looking more deeply into the data of the three studies, conflicting results were found, as two articles did not find any relationship between CM and myasthenia gravis symptoms. The remaining study only found a significant increase in symptomatology within 1 day after CT scanning: seven patients (6.3%) in the contrast-enhanced CT group and one patient (0.6%) in the unenhanced CT group (p = 0.01).
CONCLUSIONS: There is limited evidence on the relationship between CM and myasthenia gravis symptoms. In the vast majority of myasthenia gravis patients, CM are safe. Probably, in less than 5% of the patients, iodine-based CM administration may lead to increased severity of the symptoms within the first 24 h after administration.
CONCLUSIONS: Be aware that intravenous administration of iodine-based contrast media can lead to an increase of symptoms in patients with myasthenia gravis within the first 24 h. This can probably happen in less than 5% of the patients.
CONCLUSIONS: • It is unclear whether modern contrast media can lead to increased symptoms in myasthenia gravis patients after intravenous administration. • There seems to be a small risk of increased myasthenia gravis symptoms within 24 h after intravenous administration of iodine-based contrast media, probably in less than 5% of the administrations. • Gadolinium-based contrast media are safe for patients with myasthenia gravis.
METHODS: A systematic search in Medline was conducted for studies describing the symptomatology of myasthenia gravis patients before and after receiving intravenous (IV) CM and having a matched control group of myasthenia gravis patients who did not receive IV CM.
RESULTS: Three retrospective studies were selected with a total of 374 myasthenia gravis patients who received iodine-based CM and a total of 313 myasthenia gravis patients who underwent unenhanced CT and served as controls. Pooling of the data from the three retrospective studies showed that in 23 of 374 patients, increased symptoms after iodine-based CM administration were described (6.1%). Increased symptomatology also occurred in 11 of 313 patients after unenhanced CT (3.5%). When looking more deeply into the data of the three studies, conflicting results were found, as two articles did not find any relationship between CM and myasthenia gravis symptoms. The remaining study only found a significant increase in symptomatology within 1 day after CT scanning: seven patients (6.3%) in the contrast-enhanced CT group and one patient (0.6%) in the unenhanced CT group (p = 0.01).
CONCLUSIONS: There is limited evidence on the relationship between CM and myasthenia gravis symptoms. In the vast majority of myasthenia gravis patients, CM are safe. Probably, in less than 5% of the patients, iodine-based CM administration may lead to increased severity of the symptoms within the first 24 h after administration.
CONCLUSIONS: Be aware that intravenous administration of iodine-based contrast media can lead to an increase of symptoms in patients with myasthenia gravis within the first 24 h. This can probably happen in less than 5% of the patients.
CONCLUSIONS: • It is unclear whether modern contrast media can lead to increased symptoms in myasthenia gravis patients after intravenous administration. • There seems to be a small risk of increased myasthenia gravis symptoms within 24 h after intravenous administration of iodine-based contrast media, probably in less than 5% of the administrations. • Gadolinium-based contrast media are safe for patients with myasthenia gravis.
摘要：
目的：目前尚不确定现代碘基或钆基造影剂（CM）给药是否会导致重症肌无力患者症状增加。
方法：在Medline中对描述重症肌无力患者在接受静脉（IV）CM之前和之后的症状的研究进行了系统搜索，并有一个匹配的对照组的重症肌无力患者没有接受静脉CM。
结果：选择了三项回顾性研究，共374例重症肌无力患者接受碘基CM治疗，313例重症肌无力患者接受未增强CT检查并作为对照。汇集来自三项回顾性研究的数据显示，在374例患者中，有23例，描述了基于碘的CM给药后症状增加(6.1%).未增强CT后，313例患者中的11例也出现了症状学增加（3.5％）。当更深入地研究三项研究的数据时，发现了相互矛盾的结果，因为两篇文章没有发现CM和重症肌无力症状之间有任何关系。其余研究仅在CT扫描后1天内发现症状学显着增加：对比增强CT组有7名患者（6.3％），未增强CT组有1名患者（0.6％）（p=0.01）。
结论：关于CM与重症肌无力症状之间关系的证据有限。在绝大多数重症肌无力患者中，CM是安全的。可能,在不到5%的患者中，基于碘的CM给药可能导致在给药后的第一个24小时内症状的严重程度增加。
结论：请注意，静脉注射碘基造影剂可导致重症肌无力患者在最初24小时内症状增加。这可能发生在不到5％的患者中。
结论：•目前尚不清楚现代造影剂是否可导致重症肌无力患者静脉给药后症状增加。•静脉内服用碘基造影剂后24小时内，重症肌无力症状增加的风险似乎很小，可能在不到5%的行政部门中。•基于钆的造影剂对重症肌无力患者是安全的。
方法：在Medline中对描述重症肌无力患者在接受静脉（IV）CM之前和之后的症状的研究进行了系统搜索，并有一个匹配的对照组的重症肌无力患者没有接受静脉CM。
结果：选择了三项回顾性研究，共374例重症肌无力患者接受碘基CM治疗，313例重症肌无力患者接受未增强CT检查并作为对照。汇集来自三项回顾性研究的数据显示，在374例患者中，有23例，描述了基于碘的CM给药后症状增加(6.1%).未增强CT后，313例患者中的11例也出现了症状学增加（3.5％）。当更深入地研究三项研究的数据时，发现了相互矛盾的结果，因为两篇文章没有发现CM和重症肌无力症状之间有任何关系。其余研究仅在CT扫描后1天内发现症状学显着增加：对比增强CT组有7名患者（6.3％），未增强CT组有1名患者（0.6％）（p=0.01）。
结论：关于CM与重症肌无力症状之间关系的证据有限。在绝大多数重症肌无力患者中，CM是安全的。可能,在不到5%的患者中，基于碘的CM给药可能导致在给药后的第一个24小时内症状的严重程度增加。
结论：请注意，静脉注射碘基造影剂可导致重症肌无力患者在最初24小时内症状增加。这可能发生在不到5％的患者中。
结论：•目前尚不清楚现代造影剂是否可导致重症肌无力患者静脉给药后症状增加。•静脉内服用碘基造影剂后24小时内，重症肌无力症状增加的风险似乎很小，可能在不到5%的行政部门中。•基于钆的造影剂对重症肌无力患者是安全的。
