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Iodinated contrast agents in myasthenia gravis

Department of Neurology, University of Virginia Medical Center, Charlottesville, VA.

Administration of intravenous iodinated contrast agents has been reported to cause increased weakness in myasthenia gravis (MG) patients. We reviewed the records of 136 patients with MG who had at least one radiologic procedure involving intravenously administered contrast media. Seven patients (5.1%) had contrast reactions, which compares with the 5% rate of contrast reactions in the general population. Five patients had either a subjective or objective increase in weakness that could be explained by reasons other than contrast administration. Only one patient was found to have increased respiratory muscle weakness, which could have been attributed to either contrast infusion or pulmonary embolism. We conclude that intravenous contrast agents are not contraindicated in MG, but extra care should be taken when they are given.

Address correspondence and reprint requests to Dr. Phillips, Department of Neurology, Box 394, University of Virginia Medical Center, Charlottesville, VA 22908.

Received May 5, 1986. Accepted for publication in final form November 6, 1986.