If a patient has myathenia gravis should iodinated contrast be used for a chest CT?

If a patient has myathenia gravis should iodinated contrast be used for a chest CT?

Recent articles suggest that it may exacerbate myasthenic symptoms so it must be used with caution. "Intravenous administration of low-osmolality contrast material is significantly associated with exacerbation of myasthenia gravis-related symptoms. Exacerbations most commonly manifest as new or progressive acute respiratory comprimise." Effect of Intravenous Low-Osmolality Iodinated Contrast Media on Patients with Myasthenia Gravis Somashekar CK et al. Radiology 2013; 267:727-734. ntravenous administration of low-osmolality contrast material should be considered among the list of medications known to exacerbate myasthenic symptoms, with an estimated risk of acute symptoms deterioration of approximately 5-6% above baseline." Effect of Intravenous Low-Osmolality Iodinated Contrast Media on Patients with Myasthenia Gravis Somashekar CK et al. Radiology 2013; 267:727-734