Gadoteridol‐induced anaphylaxis – not a class allergy

Galera, C.; Ozygit, L. Pur; Cavigioli, S.; Bousquet, Philippe‐Jean; Demoly, Pascal

doi:10.1111/j.1398-9995.2009.02137.x

Cited by 41 publications

(38 citation statements)

References 4 publications

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“…In the case of immediate hypersensitivity reactions to MR contrast media, the pathophysiologic mechanism is largely unknown. However, some reports suggest the role of an immunoglobulin E-mediated reaction in MR contrast media-related hypersensitivity (24,25). These investigators observed positive skin reactions to the MR contrast media that caused anaphylaxis.…”

Section: Clinical Characteristics According To Immediate Hypersensitimentioning

confidence: 96%

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Jung¹,

Kang²,

Kim³

et al. 2012

Radiology

219

165

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Purpose:To determine the incidence and risk factors of immediate hypersensitivity reactions to gadolinium-based magnetic resonance (MR) contrast agents. Materials and Methods:Institutional review board approval and a waiver of informed consent were obtained. A retrospective study of patients who had been given gadolinium-based MR contrast media between August 2004 and July 2010 was performed by reviewing their electronic medical records. In addition to data on immediate hypersensitivity reaction, the kinds of MR contrast media and demographic data including age, sex, and comorbidity were collected. To compare the groups, the x 2 test, Fisher exact test, x 2 test for trend, Student t test, analysis of variance test, and multiple logistic regression test were performed. Results:A total of 112 immediate hypersensitivity reactions (0.079% of 141 623 total doses) were identified in 102 patients (0.121% of 84 367 total patients). Among the six evaluated MR contrast media, gadodiamide had the lowest rate (0.013%) of immediate hypersensitivity reactions, while gadobenate dimeglumine had the highest rate (0.22%). The rate for immediate hypersensitivity reactions was significantly higher in female patients (odds ratio = 1.687; 95% confidence interval: 1.143, 2.491) and in patients with allergies and asthma (odds ratio = 2.829; 95% confidence interval: 1.427, 5.610). Patients with a previous history of immediate hypersensitivity reactions had a higher rate of recurrence after reexposure to MR contrast media (30%) compared with the incidence rate in total patients (P , .0001). The incidence of immediate hypersensitivity reactions increased depending on the number of times patients were exposed to MR contrast media (P for trend = .036). The most common symptom was urticaria (91.1%), and anaphylaxis occurred in 11 cases (9.8%). The mortality rate was 0.0007% because of one fatality. Conclusion:The incidence of immediate hypersensitivity reactions to MR contrast media was 0.079%, and the recurrence rate of hypersensitivity reactions was 30% in patients with previous reactions.q RSNA, 2012 Supplemental material: http://radiology.rsna.org/lookup /suppl

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Section: Clinical Characteristics According To Immediate Hypersensitimentioning

confidence: 96%

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Jung¹,

Kang²,

Kim³

et al. 2012

Radiology

219

165

View full text Add to dashboard Cite

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“…In some cases, positive results were detected using undiluted contrast for skin prick tests and dilutions of 1:1000 to 1:10 for intradermal tests (grade of recommendation, D) [21][22][23]109,110]. Cross-reactivity between gadolinium chelates is still unclear [22,23,111], although it appears not to exist between macrocyclic and linear substances. In the case of immediate hypersensitivity reactions, it would be advisable to use gadolinium chelates as an alternative to the culprit, preferably with a different molecular structure (grade of recommendation, D).…”

Section: Contrast Media Used In Mrimentioning

confidence: 99%

“…In the case of immediate hypersensitivity reactions, it would be advisable to use gadolinium chelates as an alternative to the culprit, preferably with a different molecular structure (grade of recommendation, D). Skin testing should also be performed (grade of recommendation, D) [23,112].…”

Section: Contrast Media Used In Mrimentioning

confidence: 99%

“…Involvement of specific IgE has been suggested, based on positive skin test results in patients with anaphylactic reactions to MRI contrast media [20][21][22][23].…”

Section: Contrast Media Used In Mrimentioning

confidence: 99%

“…Their application has increased markedly in recent years, with gadolinium derivatives being the most frequent. Although rare, IgE-mediated reactions to MRI contrast media have been reported [20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media

Rosado¹,

Díaz²,

Moreno³

et al. 2016

J Investig Allergol Clin Immunol

122

124

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The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. Key words: Iodinated. Gadolinium. Contrast media. Allergy. Hypersensitivity. Anaphylaxis. Immediate reactions. Nonimmediate reactions. PrologueThe objective of these guidelines is to ensure efficient and effective clinical practice in the diagnosis and management of hypersensitivity reactions to radiologic contrast media. The guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) with extensive clinical expertise in the evaluation and management of hypersensitivity reactions and broad research experience.We performed a systematic and independent review of the literature up to November 2015 and established a consensus of expert opinion. We evaluated the applicability of the guidelines in our daily clinical practice. The guidelines were evaluated and criticized by external reviewers with expertise in the field. MethodThe panel of experts who produced this consensus document developed a research protocol outlining the background to the subject of study, the objectives of the study, and the questions and hypotheses from which search criteria were defined.The main sources used for the literature search included electronic databases and archives (MEDLINE-PubMed, Science Direct, OVID) and a database of systematic re...

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Current awareness: Pharmacoepidemiology and drug safety

2010

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Gadoteridol‐induced anaphylaxis – not a class allergy

Cited by 41 publications

References 4 publications

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Immediate Hypersensitivity Reaction to Gadolinium-based MR Contrast Media

Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media

Current awareness: Pharmacoepidemiology and drug safety

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