Hypersensitivity to gadolinium-based contrast agents: A single-center retrospective analysis over 7 years

Gadolinium-Based Contrast Agents Hypersensitivity: A Case Series

“…8 As Jung et al previously indicated, 4 in our experience, gadobenate dimeglumine was the more frequent agent implicated in the hypersensitivity reactions. Differently, in a retrospective analysis of patients investigated by Mankouri et al 9 gadoteric acid was the most frequently GBCA reported by patients as the cause of a reaction, followed by gadobenic acid. Two of the three patients who had a reaction with a linear GBCA showed a cross-reactivity also for a macrocyclic agent having the same net charge.…”

“…Cross-reactivity in skin tests has recently been demonstrated in one third of allergic patients. 9 However, some previous reports showed no cross-reactivity between GBCAs 10 , 11 while others showed cross-reactivity between gadobutrol and gadoteridol 12 and between gadobutrol and several both linear and macrocyclic agents. 9 , 13 These findings cannot allow us to draw any conclusion on cross-reactivity and further studies are needed to clarify this mechanism.…”

“… 9 However, some previous reports showed no cross-reactivity between GBCAs 10 , 11 while others showed cross-reactivity between gadobutrol and gadoteridol 12 and between gadobutrol and several both linear and macrocyclic agents. 9 , 13 These findings cannot allow us to draw any conclusion on cross-reactivity and further studies are needed to clarify this mechanism. In our experience, only the case 2 showed the reaction after repeated exposures to GBCAs, while the other cases presented symptoms during their first exposure.…”

“…Reaction after first exposure to a drug has already been described by Hasdenteufel et al 14 and could be due to work exposure (in metallurgical plants, magnet manufacturers, fluorescent lamps, or television sets), to exposure to GBCAs in drinking water 15 or to particular characteristics of these drugs. Based on high reported negative predictive value, 9 , 14 in previous reactors skin testing seems to be a useful tool in selection of a safe product for their future MRIs. For these reasons, although none of our patients have undergone further MRIs, we advised them to use negative skin test for GBCAs for the future.…”

Patterns of Cross-Reactivity in Patients With Immediate Hypersensitivity Reactions to Gadobutrol

“…Cross-reactivity among GBCAs has not been adequately addressed [1,2,3,6,7,8,12]. Kolenda et al [7] described 30 patients with immediate reactions to GBCAs, finding J Investig Allergol Clin Immunol 2021; Vol.…”