Fatal non-cardiogenic pulmonary oedema after intravenous nonionic radiographic contrast

Life-threatening reactions to radiographic contrast media are rare. We describe a case of fatal non-cardiogenic pulmonary oedema, after use of iopamidol, a widely used, low osmolar, non-ionic, radiographic contrast medium. A woman with a history of bladder tumour who had haematuria was referred for an intravenous urogram. After intravenous injection of 100 mL iopamidol, the woman became short of breath, and a chest radiograph showed severe pulmonary oedema. She was treated but subsequently died. The pathogenesis of contrastinduced, non-cardiogenic pulmonary oedema is unclear, and treatment differs from that for cardiogenic pulmonary oedema.