Hypersensitivity Reactions to Iodinated Contrast Media: Is it a True Allergy?

Moreno, Esther; Bara, María Teresa Gracia; Mayorga, Cristobalina; Lázaro, Milagros; Campanón, M. Valle; Dávila, Ignacio

doi:10.1007/s40521-018-0154-8

Cited by 2 publications

(7 citation statements)

References 73 publications

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“…Also, provocation tests with ICM have been used mainly in patients with a history of severe reactions to identify alternative ICMs in a safer setting. 49 On the other hand, in less severe cases, skin test-negative ICM reexposition at the radiology department may also suffice when the ICM is needed for diagnosis.…”

Section: Unmet Needsmentioning

confidence: 99%

Diagnosis and Prevention of Hypersensitivity Reactions to Iodinated Contrast Media

Kang

Jeong

Brockow

2022

Allergy Asthma Immunol Res

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Iodinated contrast media (ICM) have become one of the major causes of drug hypersensitivity reactions (HSRs) related to increasing numbers of ICM-based radiological imaging procedures. Strategies for diagnosing and preventing ICM-induced HSRs have not been uniformly standardized yet. However, advances have been made based on the results of recent research. A previous history of hypersensitivity to ICM is the most significant risk factor for developing HSR by ICM. Avoidance of culprit agents and premedication is the main strategy to prevent recurrences of HSRs in high-risk patients. In addition, we strongly recommend identifying sensitized ICM using skin tests to determine immunoglobulin E-mediated or delayed-type allergy and to guide the choice of an alternative contrast agent. ICM provocation test procedures have been established and are helpful in selected cases. In this paper, we review how to evaluate patients who have experienced immediate or delayed HSRs caused by ICM to minimize the risk of recurrence and discuss unmet needs that require further research.

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Section: Unmet Needsmentioning

confidence: 99%

Diagnosis and Prevention of Hypersensitivity Reactions to Iodinated Contrast Media

Kang

Jeong

Brockow

2022

Allergy Asthma Immunol Res

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“…Radiographic contrast media are a group of medical drugs used to improve the visibility of internal fluid, organs and structures in medical imaging, such as angiography, computed tomography, diagnostic X-ray (radiology) and in radiotherapy for treatment planning (Therapeutically in hyperthyroid patients, to rapidly correct severe hyperthyroidism prior to thyroidectomy). The currently available contrast media are indispensable in the practice of radiology, for both diagnostic and therapeutic purposes [1,2,3]. The number of medical procedures using iodinated contrast media has dramatically increased in recent decades [3].…”

Section: Introductionmentioning

confidence: 99%

“…The currently available contrast media are indispensable in the practice of radiology, for both diagnostic and therapeutic purposes [1,2,3]. The number of medical procedures using iodinated contrast media has dramatically increased in recent decades [3]. They are usually excreted within 24 hours [4].…”

Section: Introductionmentioning

confidence: 99%

“…[6,7]. Although intravenous contrast mediums are well-tolerated and safe compounds, with rare adverse effects [3], one of such is Contrast-induced nephropathy, a well-known adverse reaction associated with the use of intravenous or intraarterial contrast material. Other forms of adverse reactions include delayed allergic reactions, anaphylactic reactions, and cutaneous reactions [2,7].…”

Section: Introductionmentioning

confidence: 99%

“…Hence, the need to premedicate with corticosteroid and diphenhydramine to reduce the chance of life-threatening emergencies. Examples of these premedication drugs are, prednisone at 50 mg orally, 13 hr, 7 hr, and 1 hr before contrast media administration; hydrocortisone at 200 mg intravenously, 1 hr before contrast media administration; methylprednisolone 32 mg orally, 12 and 2 hr before contrast media administration is used [3]. The mechanisms leading to contrast media nephrotoxicity have not been fully elucidated, but it is generally attributed to severe reduction in medullary blood flow, leading to hypoxia and direct tubular damage due to toxicity of contrast media.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of dexamethasone and methylprednisolone administration on visceral organs prior to contrast radiography in Nigerian indigenous breed of dogs

Kalang¹,

Bata²,

Malam³

et al. 2022

GSC Biol. Pharm. Sci.

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The number of medical procedures using iodinated contrast media has increased in recent decades, though contrast media are regarded as safer. Nine Nigerian indigenous breed of dogs were acquired and housed in the Small Animal Kennel of the Nigerian Veterinary Research Institute Veterinary Hospital. The nine dogs were grouped into three groups of three animals each. Group A was the control, and were given urografin at 370 mg/kg, ten minutes before exposure to x-ray. Group B were given dexamethasone at 1 mg/kg 2 hours before x-ray and urografin ten minutes before exposure to x-ray. Group C were given methylprednisolone at 1 mg/kg 2 hours before exposure to x-ray, and urografin ten minutes before exposure to x-ray. All groups were given urografin 24 hours later at 370 mg/kg. Pathological changes in the liver and the kidney were more severe in the methylprednisolone treated group, followed by dexamethasone treated group. While, the dexamethasone treated group recorded more pathologies in the spleen. The use of anti-inflammatory drugs (dexamethasone and methylprednisolone) tends to be more protective in the heart. We recommend that the use of steroids such as dexamethasone and methylprednisolone be avoided in contrast radiography except where heart pathology exist

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Hypersensitivity Reactions to Iodinated Contrast Media: Is it a True Allergy?

Cited by 2 publications

References 73 publications

Diagnosis and Prevention of Hypersensitivity Reactions to Iodinated Contrast Media

Diagnosis and Prevention of Hypersensitivity Reactions to Iodinated Contrast Media

Evaluation of dexamethasone and methylprednisolone administration on visceral organs prior to contrast radiography in Nigerian indigenous breed of dogs

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