Hypersensitivity to Contrast Media and Dyes

Brockow, Knut; Sánchez-Borges, Mario

doi:10.1016/j.iac.2014.04.002

Cited by 67 publications

(70 citation statements)

References 121 publications

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“…Contrast agents are known to be generally safe with minimal risk of HSR 21 . Our results of overall ferumoxytol related AE rates occurring in 10.6% infusions, most of them occurring within 48h (8.6%) are in concordance with AE rates between 10–14.6% published in the literature based on three randomized trials for iron replacement.…”

Section: Discussionmentioning

confidence: 99%

What Does the Boxed Warning Tell Us? Safe Practice of Using Ferumoxytol as an MRI Contrast Agent

Várallyay¹,

Tóth²,

et al. 2017

AJNR Am J Neuroradiol

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Background and Purpose Despite the label change and FDA’s boxed warning added to the Feraheme® (ferumoxytol, AMAG Pharmaceuticals, Waltham, MA) label in March 2015, radiologists have shown increasing interest in using ferumoxytol as an MRI contrast agent as a supplement or alternative to gadolinium. The goals of this study are to provide information regarding ferumoxytol safety as an imaging agent in a single center, and to assess how Feraheme® label change may affect this potential, currently off label indication. Materials and Methods This retrospective study evaluated the overall frequency of ferumoxytol related adverse events (AEs) when used for CNS MRI. Subjects with various CNS pathologies were enrolled in Institutional Review Board approved imaging studies. Ferumoxytol was administered as multiple rapid bolus injections. The risk of AEs was correlated with demographic data/medical history. Results Safety of 671 ferumoxytol enhanced MR studies in 331 subjects was analyzed. No anaphylaxis, life-threating or fatal (grade 4 or 5) AE was recorded. The overall proportion of ferumoxytol related grade 1–3 AE was 10.6% (8.6% occurring within 48h), including hypertension (2.38%), nausea (1.64%), diarrhea (1.04%) and headache (1.04%). History of one or two allergies was associated with increased risk of AE (14.61% vs. no allergies of 7.51%, p=0.0069). Conclusion The frequency of mild ferumoxytol related AE was comparable with literature results, and no serious AE was recorded. While the recommendations in the boxed warning should be followed, serious AE appear to be rare events and with proper precautions ferumoxytol may be a valuable MRI agent.

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Section: Discussionmentioning

confidence: 99%

What Does the Boxed Warning Tell Us? Safe Practice of Using Ferumoxytol as an MRI Contrast Agent

Várallyay¹,

Tóth²,

et al. 2017

AJNR Am J Neuroradiol

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“…T he use of iodinated contrast media (ICM) in conjunction with computed tomographic (CT) scans can cause various adverse effects, ranging from mild reactions to fatal adverse reactions such as anaphylaxis. Because of the recent rise in use of ICM, the number of adverse reactions to ICM may also increase (1).…”

mentioning

confidence: 99%

Immediate Mild Reactions to CT with Iodinated Contrast Media: Strategy of Contrast Media Readministration without Corticosteroids

Park¹,

Kang²,

Sohn³

et al. 2018

Radiology

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Purpose To evaluate premedication protocols involving administration of antihistamine and multidose corticosteroid that have been widely used in prevention of recurrent hypersensitivity reactions (HSRs) to iodinated contrast media (ICM); an evidence-based optimal preventive strategy customized for patients with mild cases has not yet been established. Materials and Methods The outcomes of patients with mild HSR who subsequently underwent contrast material-enhanced computed tomography (CT) between January 2012 and December 2015 were analyzed. For premedication, 4 mg of chlorpheniramine was intravenously administered 30 minutes prior to reexposure to ICM. Logistic regression with generalized estimating equations was used to determine the relationship between premedication and recurrence rate. Results A total of 1178 patients with mild immediate HSR were reexposed to ICM 3533 times. Among these patients, 1056 patients experienced allergylike reactions and 122 patients developed gastrointestinal reactions. With reexposure to the culprit agent without premedication, the recurrence rate was 31.1% (85 of 273 examinations). The recurrence rate decreased to 12% (105 of 872 examinations; P < .001) by only changing the culprit agent and to 7.6% (148 of 1947 examinations; P < .001) by using the combination of changing the ICM and antihistamine premedication. Changing the ICM plus antihistamine premedication was also helpful in reducing the recurrence of gastrointestinal symptoms from 16.1% to 1.8% (P = .020). However, despite changing of the ICM, some combinations of ICM did not show a prophylactic effect. Conclusion A combination of changing the culprit agent and antihistamine premedication resulted in the best preventive outcome for patients with mild immediate HSR. The optimal choice of substitute ICM could be individualized according to the culprit agent.

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“…30 Hitherto, three studies reported on the value of BAT in the diagnosis of IDHR to RCM ( Table 3). [31][32][33] These studies demonstrate a sensitivity of 46-63% depending on the chosen threshold, and a specificity of 89-100%.…”

Section: Discussionmentioning

confidence: 99%

Flow-assisted basophil activation tests in immediate drug hypersensitivity: two decades of Antwerp experience

Mangodt

Gasse

Bastiaensen

et al. 2016

Acta Clinica Belgica

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The last two decades have witnessed that flow-assisted analysis of in vitro-activated basophils can constitute a valuable adjunct in the in vitro diagnostic approach of immediate drug hypersensitivity reactions (IDHR). This article summarises the current experience with the basophil activation test in the diagnosis of IDHR, with particular focus on allergy to curarising neuromuscular blocking agents, antibiotics (β-lactams and fluoroquinolones), iodinated radiocontrast media and opiates.

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Hypersensitivity to Contrast Media and Dyes

Cited by 67 publications

References 121 publications

What Does the Boxed Warning Tell Us? Safe Practice of Using Ferumoxytol as an MRI Contrast Agent

What Does the Boxed Warning Tell Us? Safe Practice of Using Ferumoxytol as an MRI Contrast Agent

Immediate Mild Reactions to CT with Iodinated Contrast Media: Strategy of Contrast Media Readministration without Corticosteroids

Flow-assisted basophil activation tests in immediate drug hypersensitivity: two decades of Antwerp experience

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