Myasthenia gravis is included in the “precautions for use” of iodinated contrast products because of a possible worsening of the symptoms of the disease caused by their injection. After analysing the sometimes contradictory results of three retrospective studies, the Contrast Products Safety Committee of the European Society of Urogenital Radiology updated its recommendations on the subject (grade 4):
- intravenous administration of an iso- or hypo-osmolar iodine-based contrast agent may well be associated with an exacerbation of myasthenia symptoms within 24 hours,
- this aggravation probably occurs in less than 5% of cases,
- gadolinium-based contrast products are safe in patients with myasthenia.