Desensitisation as a Means of Preventing Untoward Reactions to Ionic Contrast Media

Abstract

Patients with a previous history of anaphylactic reactions to ionic iodinated contrast media were desensitised before a second radiologic examination was performed. The tolerance to the contrast medium was raised by repeated intravenous injections in increasing doses and concentrations. No serious side effects were noted when the examinations with contrast medium was repeated within a few days after the desensitisation. The positive effect of the desensitisation may depend on a successive consumption of complement proteins, probably responsible for the allergic reactions. Therefore, the available amount of complement for some days may be too low for the occurrence of a complement reaction.

MR Lumbar Discography with Intradiscal Gadolinium in Patients with Severe Anaphylactoid Reaction to Iodinated Contrast Material

“…Rapoport et al referred to a personal communication with Speck that stated thousands of metrizamide myelographies had been associated with only a few anaphylactoid reactions [19]. Adverse reactions, including urticaria and angioedema, associated with metrizamide myelography have been reported [20,21]. Tallroth retrospectively reported the safety of myelography using metrizamide and a premedication regimen in patients with previous adverse reactions to iodinated contrast material, but only three of 26 patients included had a previous history of a severe anaphylactoid reaction [22].…”

The use of gadolinium in patients with contrast allergy or renal failure requiring coronary angiography, coronary intervention, or vascular procedure

“…Therefore, this method may be considered in some patients with history of iodine contrast allergy. However, in patients with history of anaphylactic reaction to iodine contrast, desensitizing procedure could be risky [17].…”