Skin tests for the exploration of hypersensitivity reactions associated with iodinated contrast media

2021 ◽  
Vol 16 ◽  
Author(s):  
Ahmed Zaiem ◽  
Syrine Ben Hammamia ◽  
Fares Ben Salem ◽  
Ons Charfi ◽  
Imen Aouinti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Hypersensitivity Reaction ◽  
Contrast Media ◽  
Skin Testing ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
Intradermal Tests ◽  
The One

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.

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
Keyword(s):  
Contrast Media ◽  
Skin Testing ◽  
Skin Tests ◽  
Iodinated Contrast Media ◽  
Provocation Tests ◽  
Iodinated Contrast ◽  
Intradermal Tests ◽  
Ige Mediated ◽  
Low Prevalence ◽  
Work Up

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.

scholarly journals Hypersensitivity reactions to iodinated contrast media

2019 ◽  
Vol 16 (3) ◽  
pp. 85-91
Author(s):  
L G Khludova ◽  
T N Myasnikova ◽  
V V Smirnov ◽  
T V Latysheva ◽  
M R Khaitov
Keyword(s):  
Contrast Media ◽  
Contrast Agents ◽  
Previous History ◽  
Skin Tests ◽  
Public Health Issue ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
Alternative Agent ◽  
History Of

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.

scholarly journals Features of delayed hypersensitivity reactions to iodinated contrast media diagnosis. Clinical cases

2013 ◽  
Vol 10 (3) ◽  
pp. 35-40
Author(s):  
N V Lebedeva ◽  
T N Myasnikova ◽  
T V Latysheva
Keyword(s):  
Contrast Media ◽  
Delayed Hypersensitivity ◽  
Skin Tests ◽  
Delayed Type Hypersensitivity ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast ◽  
History Of ◽  
Clinical Cases

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.

Skin tests in patients with hypersensitivity reaction to iodinated contrast media: a meta-analysis

Allergy ◽  
2015 ◽  
Vol 70 (6) ◽  
pp. 625-637 ◽  
Author(s):  
S. H. Yoon ◽  
S.-Y. Lee ◽  
H.-R. Kang ◽  
J.-Y. Kim ◽  
S. Hahn ◽  
...  
Keyword(s):  
Hypersensitivity Reaction ◽  
Contrast Media ◽  
Meta Analysis ◽  
Skin Tests ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

scholarly journals Utility of Skin Tests for Diagnosis of Hypersensitivity Reactions to Iodinated Contrast Media

2019 ◽  
Vol 143 (2) ◽  
pp. AB60
Author(s):  
Gintarė Paulikaitė ◽  
Laura Malinauskienė ◽  
Anzelika Chomiciene ◽  
Kęstutis Černiauskas ◽  
Kotryna Linauskienė ◽  
...  
Keyword(s):  
Contrast Media ◽  
Skin Tests ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

scholarly journals Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033023
Author(s):  
Hiroyasu Umakoshi ◽  
Takashi Nihashi ◽  
Hironori Shimamoto ◽  
Takehiro Yamada ◽  
Hiroaki Ishiguchi ◽  
...  
Keyword(s):  
Contrast Media ◽  
Assessment Tools ◽  
Average Risk ◽  
Cochrane Central Register ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Preventive Interventions ◽  
Validity Assessment ◽  
Iodinated Contrast ◽  
Standard Design

IntroductionIodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions.Methods and analysisWe will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate.Ethics and disseminationEthics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal.PROSPERO registration numberCRD42019134003

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