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November 12, 1960

Low-Molecular-Weight Dextran

JAMA. 1960;174(11):1417-1422. doi:10.1001/jama.1960.63030110005012

Toxic reactions to currently employed iodinated water-soluble radiopaque media have been responsible for the occurrence of considerable morbidity and some deaths after such diagnostic procedures as cardioangiography, aortography, arteriography, and pyelography.7, 12, 23 The mechanism of these reactions has been the subject of intense clinical interest for some time. However, until quite recently, no satisfactory explanation for many of the observed clinical and experimental reactions had been advanced.21 The role of allergic phenomena has been seriously challenged by Sandstrom,26 who clearly indicates that there is no evidence for the value of pretesting or prophylaxis, history of previous contact, or proof of antigen-antibody reaction. Other authors agree that pretesting and prophylactic antihistaminics are of little value in predicting or preventing these reactions.12

Recent studies by Read24 have demonstrated that the phenomenon of diffuse intravascular red-blood-cell sludging occurs after the intravenous injection of a number of hypertonic

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