Analysis of cross-reactivity among radiocontrast media in 97 hypersensitivity reactions

Lerondeau, B.; Tréchot, P.; Waton, J.; Poreaux, C.; Luc, Amandine; Schmutz, J.‐L.; Paris, Christophe; Barbaud, A.

doi:10.1016/j.jaci.2015.07.035

Cited by 69 publications

(105 citation statements)

References 11 publications

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“…Three groups of ICM agents have been identified as frequently showing cross-reactivity, but cross-reactions among ICM agents do not follow the current chemical classification. 11 In our case, the only negative test result was with an agent not used for coronary artery imaging. However, the patient needed coronary stenting and valvuloplasty, thus requiring further coronarography.…”

Section: Discussionmentioning

confidence: 56%

Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication

et al. 2019

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K E Y W O R D S : acute generalized exanthematous pustulosis, case report, cross-reactivity, delayed adverse drug reactions, iodinated contrast media reactions, iomeprol Hypersensitivity reactions to iodinated contrast media (ICM) are rare and occur within 1 hour after infusion, but also up to 7 days later. 1 Delayed reactions may be under-reported, because they may appear after patient discharge. 2 Reactions are usually mild to moderate, but more severe cases, including generalized acute generalized exanthematous pustulosis (AGEP), have been reported. 3,4 Patch testing helps in identifying the culprit drug in AGEP, 5 and may help in choosing an alternative therapy when a new radiological examination involving ICM infusion is required. 6 CASE REPORTAn 88-year-old patient underwent three radiological examinations requiring intravenous infusion of iomeprol within a few days for preoperative assessment of aortic stenosis and ischaemic heart disease. Prior medication included furosemide, paracetamol, and simvastatin, all of which were taken for >1 year. At 24 hours after the third injection, the patient was admitted for acute exanthema, with a temperature of 39.9 C ( Figure 1A). Numerous pustules were present on the face (Figure 1B), axillary folds, and trunk. Blood tests showed leukocytosis, at 21 g/L, with polymorphonuclear cells at 19 g/L. A skin biopsy showed an intraepidermal pustule with numerous polymorphonuclear cells.Patch testing was performed 6 months after the occurrence of AGEP. Tests with ioxitalamate (++), iohexol (+++), iomeprol (+++), iobitridol (++), iopamidol (++), ioversol (+++), iodixanol (+++) and iopromide (+) gave positive reactions. A test with amidotrizoate gave a 74MACHET ET AL.

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Section: Discussionmentioning

confidence: 56%

Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication

et al. 2019

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“…A recent study on cross‐reactivity among ICM in 97 patients (38 immediate, 50 delayed, and nine not recorded HSR) with at least one positive skin test result and/or non‐tolerated challenge (up to 10 −1 of the usual dose) identified 3 subgroups of ICM in which cross‐reactions were frequent; group A (iodixanol, iopamidol, iomeprol, iohexol, ioversol, and ioxithalamate), group B (ioxaglate and iobitridol), and group C with an isolated ICM amidotrizoate. This new ICM classification seemed been statistically significant in delayed HSR . The volume of ICM injected during a radiologic examination varies from 10 mL to 200 mL.…”

Section: Discussionmentioning

confidence: 84%

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Sesé

Gaouar

Autegarden

et al. 2016

Clin Experimental Allergy

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“…A study on cross‐reactivity among radiocontrast media identified three subgroups of radiocontrast media in which cross‐reactions were frequent. Iodixanol and iohexol were in the same subgroup, the members of which share two identical N ‐(2,3‐dihydroxypropyl) carbamoyl side chains . Moreover, two previous studies reported frequent cross‐reactions between iodixanol and iohexol, iohexol being the monomer of iodixanol .…”

Section: Discussionmentioning

confidence: 99%

Acute generalized exanthematous pustulosis caused by an iodinated contrast radiocontrast medium for computed tomography arthrography of the knee

et al. 2017

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Analysis of cross-reactivity among radiocontrast media in 97 hypersensitivity reactions

Cited by 69 publications

References 11 publications

Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication

Acute generalized exanthematous pustulosis induced by iomeprol with cross‐reactivity to other iodinated contrast agents and mild reactions after rechallenge with iopromide and oral corticosteroid premedication

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Acute generalized exanthematous pustulosis caused by an iodinated contrast radiocontrast medium for computed tomography arthrography of the knee

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