Fatal acute vasculitis after high-dose urography with iohexol

The introduction of low-osmolar contrast agents such as iohexol has significantly reduced the incidence of adverse reactions in patients having intravenous urography. To our knowledge, there have been no deaths associated with the use of this drug reported to date. We describe a patient who developed a fulminating peripheral vasculitis 48 h after high-dose urography using iohexol. Death occurred 13 days later. A 69-year-old female with a 20-year history of hypertension and associated mild chronic renal failure was admitted for investigation of anaemia and sudden deterioration in her renal function. The hypertension had been controlled for the last 4 years with hydralazine (100 mg daily), atenolol (100 mg daily) and Navidrex K (Ciba Laboratories).