scholarly journals Immediate Reactions to Iodinated Contrast Media Prevalence of IgE-mediated Hypersensitivity

2020 ◽  
Author(s):  
Juliette Caron ◽  
Maxime SEYNAVE ◽  
Sahara GRAF ◽  
Tomas MORALY ◽  
Christine DELEBARRE-SAUVAGE

Abstract BackgroundAfter administration of iodinated contrast media (ICM) some patients develop an immediate hypersensitivity reaction (IHR). A specific allergic IgE-mediated mechanism may be involved. ObjectiveTo determine the prevalence of allergic patients among ICM reactors and to evaluate the negative predictive value (NVP) of skin testing for ICM.MethodsAll patients who attended a single center for an allergy work-up between 2010 and 2019 due to a prior IHR after an ICM injection were included retrospectively. ICM allergy was diagnosed if prick tests or intradermal tests were positive. Further information concerning secondary exposure to ICM was obtained from all patients with negative skin tests to determine whether ICM re-exposure led to an IHR.ResultsSkin tests identified ICM allergy in 7 out of 85 patients (8.2%). Frequency of IgE-mediated hypersensitivity among patients increased with increasing reaction severity. The NPV of skin testing for ICM allergy was 87.8% [95%CI 75.2;95.4.ConclusionThe low prevalence of IgE-mediated hypersensitivity among patients with IHR to ICM should not delay allergy workup. Earlier skin tests and provocation tests with skin-test negative ICM may help allergists to find a reliable alternative ICM.

2021 ◽  
Vol 16 ◽  
Author(s):  
Ahmed Zaiem ◽  
Syrine Ben Hammamia ◽  
Fares Ben Salem ◽  
Ons Charfi ◽  
Imen Aouinti ◽  
...  

Background: Iodinated contrast media (ICM) are responsible for multiple side effects, especially hypersensitivity reactions. These reactions can either be authentic allergies, or non-allergic hypersensitivity reactions. Skin tests (prick and intradermal tests) are simple to perform and can be of great help, especially if the ICM need to be re-used. The aim of the study was to assess the characteristics of the patients in whom skin tests were performed, and the results of these tests. Methods: This is a retrospective study from June 2014 to June 2019. All included patients had at least one episode of hypersensitivity reaction to ICM and underwent skin tests. Results : We included 35 patients aged 18 to 85 years. The iopromide was the most implicated ICM. The reactions were mainly cutaneous (n=30) and immediate (n=27). The skin tests were negative, except for two patients. The reuse of ICM occured in 11 patients: 9 with an ICM other than the one suspected and two patients with the same ICM. Among these patients, 5 did not have any premedication. Two of them had a second hypersensitivity reaction, the first with another ICM and the second with the same ICM. Conclusion: One of the main pillars of allergic exploration is ICM skin testing, not only to prevent recurrence, but also to allow patients to benefit from ICM reuse, which are sometimes essential.


2021 ◽  
Vol 14 (3) ◽  
pp. e240050
Author(s):  
Joana Carvalho ◽  
Georgeta Oliveira

Beta-lactam (BL) antibiotics are the most frequent cause of drug hypersensitivity in children, inducing both immediate and non-immediate reactions. Here we report a case of a 4-year-old child with a disseminated maculopapular exanthema 7 days after the first dose of amoxicillin–clavulanate, referred to our paediatric allergy department. Skin prick tests were negative. Intradermal tests were performed and, after 10 hours, indurated wheals larger than 10×10 mm with progressive erythema and disseminated maculopapular eruption were developed, related to amoxicillin and amoxicillin–clavulanate. Systemic reactions to BL skin tests are rarely reported and the majority are immediate reactions. This case illustrates a rare example of a non-immediate systemic reaction to intradermal tests, underlying the importance of skin testing before drug provocation tests in cases of moderate to severe non-immediate reactions.


2007 ◽  
Vol 119 (1) ◽  
pp. S269
Author(s):  
A.F.F. Ferrão ◽  
R.P. Reis ◽  
L.A. Patricio ◽  
M.R. Viseu ◽  
S.H. Correia ◽  
...  

2019 ◽  
Vol 16 (3) ◽  
pp. 85-91
Author(s):  
L G Khludova ◽  
T N Myasnikova ◽  
V V Smirnov ◽  
T V Latysheva ◽  
M R Khaitov

Hypersensitivity reactions to iodinated contrast media are a pressing public health issue. Lack of understanding of pathogenetic mechanisms of such reactions leads to unjustified refuse of diagnostic and therapeutic procedures using iodinated contrast agents. Reactions of hypersensitivity to other iodine-containing medications are not a contraindication for use of contrast agents. Skin allergy tests are only performed in the patients who had a history of allergic reactions to iodinated contrast media. Usually it is possible to determine an alternative agent by means of skin tests. Premedication before a contrast-enhanced radiological examination has to be indicated to all patients with previous history of allergic disease.


2015 ◽  
Vol 30 (3) ◽  
pp. 245 ◽  
Author(s):  
Young-Hwan Ahn ◽  
Young-Il Koh ◽  
Joo-Hee Kim ◽  
Ga-Young Ban ◽  
Yeon-Kyung Lee ◽  
...  

2013 ◽  
Vol 10 (3) ◽  
pp. 35-40
Author(s):  
N V Lebedeva ◽  
T N Myasnikova ◽  
T V Latysheva

The article presents the proprietary data of the survey of patients who had undergone a history of hypersensitivity reactions after administration of iodinated contrast media (RCM), the estimation of skin tests with RCM in these patients and two clinical cases of patients who had a history of delayed-type hypersensitivity.


Author(s):  
L.G. Khludova ◽  
T.N. Myasnikova ◽  
V.V. Smirnov ◽  
T.V. Latysheva ◽  
M.R. Khaitov

Реакции гиперчувствительности на йодосодержащие рентгенконтрастные средства являются актуальной проблемой здравоохранения. Непонимание механизмов развития таких реакций приводит к необоснованным отказам от проведения диагностических и лечебных процедур с применением йодосодержащих контрастных средств. Реакции на другие содержащие йод препараты не являются противопоказанием к введению контрастов. Кожные пробы рентгенконтрастными веществами проводятся только пациентам, перенесшим реакцию на йодосодержащее контрастное средство в анамнезе. Обычно в результате тестирования удается подобрать альтернативный препарат. Пациентам с отягощенным аллергологическим анамнезом показано проведение премедикации перед рентгенконтрастным исследованием.Hypersensitivity reactions to iodinated contrast media are a pressing public health issue. Lack of understanding of pathogenetic mechanisms of such reactions leads to unjustified refuse of diagnostic and therapeutic procedures using iodinated contrast agents. Reactions of hypersensitivity to other iodinecontaining medications are not a contraindication for use of contrast agents. Skin allergy tests are only performed in the patients who had a history of allergic reactions to iodinated contrast media. Usually it is possible to determine an alternative agent by means of skin tests. Premedication before a contrastenhanced radiological examination has to be indicated to all patients with previous history of allergic disease.


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