Leticia Paul, a 22-year-old law graduate from Lontras in southern Brazil, died less than 24 hours after going into anaphylactic shock during a contrast-enhanced CT scan on August 20, 2025, at Alto Vale Regional Hospital in Rio do Sul. She had a history of kidney stones.
Law graduate, 22, dies after allergic reaction to CT contrast in Brazil
Leticia Paul, a 22-year-old law graduate from Lontras in the southern Brazilian state of Santa Catarina, died less than 24 hours after suffering a severe allergic reaction during a contrast-enhanced CT scan, according to local and international reports. The scan took place on August 20, 2025, at Alto Vale Regional Hospital in nearby Rio do Sul.
According to reports, Paul had a history of kidney stones and was regularly seen by doctors. She was undergoing an abdominal and pelvic CT scan when she reacted to the contrast agent, went into anaphylactic shock and was intubated. She died less than a day later.
Paul had recently completed her law degree and was continuing her studies in real estate and business law, reports said.
Hospital response
The hospital expressed condolences to the family and said in a statement that it regretted the loss and stood by its commitment to ethics, transparency and patient safety. It said the procedure followed recommended clinical protocols.
No finding of negligence has been announced. Reviews after an adverse event like this one typically examine screening records, response times and medication logs.
What contrast CT is and why it is used
A contrast-enhanced CT scan uses an iodine-based dye, injected into a vein, to make blood vessels and organs show up more clearly. Doctors use it to look for bleeding, clots, infections, tumors and other problems that may be harder to see on a scan without contrast.
Many kidney stone scans are done without contrast. Doctors may add it when they need to check for infection, blockage or other causes of abdominal pain, weighing the diagnostic benefit against the risks.
How rare are severe reactions?
Most people receive iodinated contrast without any problem. A small share have mild allergic-like reactions such as itching or hives. Severe reactions, including anaphylaxis with airway swelling and a sudden drop in blood pressure, are rare with modern low-osmolality contrast agents, and deaths are rarer still.
The strongest known risk factor is a previous reaction to contrast. Other factors can include severe or poorly controlled asthma. Radiology guidelines say that a shellfish allergy on its own does not specifically raise the risk of a contrast reaction.
Standard safety measures
Imaging departments that give contrast keep emergency equipment and medicines on hand, including epinephrine, oxygen, IV fluids and airway tools. Staff are trained to recognize a reaction quickly, and epinephrine is the first-line treatment for anaphylaxis.
In the United States, many departments follow the American College of Radiology’s Manual on Contrast Media, which covers patient screening, premedication for higher-risk patients and emergency treatment steps. For patients with a known prior reaction, doctors may premedicate, use a different agent or choose another test such as ultrasound, a non-contrast CT or MRI. None of these steps removes the risk entirely.
What patients can do
- Tell the care team about any past reaction to contrast dye, as well as severe asthma or other serious allergies.
- Ask why contrast is needed for your scan and whether a non-contrast option would answer the same question.
- Speak up right away if you feel unwell, itchy, short of breath or lightheaded during or after the injection.
- If you have had a reaction, keep a record of it so future doctors can plan accordingly.
A community in mourning
Paul’s death drew tributes from friends, classmates and residents of Lontras and the surrounding Alto Vale do Itajaí region, who remembered a young lawyer at the start of her career. Her family held funeral services in the days after her death.
Source: Radiology Business
