Prediction of severe adverse reactions to ionic and nonionic contrast media in Japan: evaluation of pretesting. A report from the Japanese Committee on the Safety of Contrast Media.

Yamaguchi, Koichi; Katayama, H; Takashima, T; Kozuka, Takenori; Seez, P; Matsuura, Kazuki

doi:10.1148/radiology.178.2.1987594

Cited by 72 publications

(25 citation statements)

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“…This could be due to the fact that pretesting by intravenous injection of a small amount of CM is frequently performed in Japan as a means of predicting severe reactions [36]. It could also be due to ethnic differences, differences in type of medication used or due simply to a longer observation period practiced in Japan.…”

Section: Risk Factorsmentioning

confidence: 99%

Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations

Christiansen¹,

Pichler

Skotland³

2000

European Radiology

125

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Iodinated X-ray contrast media are among the most frequently used pharmaceuticals for intravascular administration. Although the newer low osmolality, nonionic contrast media, are generally well tolerated, it is well known that they, like the ionic contrast media, give rise to immediate or delayed adverse reactions in susceptible individuals. In the present review, the delayed allergy-like reactions, which by definition occur more than 1 h after contrast medium administration, are described, and the possible pathophysiological mechanisms discussed. Delayed allergy-like reactions to contrast media, which have been reported to occur in 0.5-2% of recipients, are mainly mild to moderate skin reactions of the maculopapular exanthematous and urticarial/angioedematous types. Most of the reactions become apparent after a latency of 3 h to 2 days and disappear within 1 week. The incidence of more severe reactions is extremely low. Main risk factors for delayed allergy-like reactions appear to be a previous contrast medium reaction, a history of allergy, IL-2 treatment and being of Japanese descent. At present, the exact pathogenesis of these delayed reactions is still unclear. There is, however, increasing evidence that a significant proportion of the reactions are T-cell mediated.

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Section: Risk Factorsmentioning

confidence: 99%

Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations

Christiansen¹,

Pichler

Skotland³

2000

European Radiology

125

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“…Pretesting patients to detect those who have an increased likelihood of having anaphylaxis-like reaction to CM, either intravenously or coetaneous, has been abandoned because it is insensitive and potentially dangerous [25][26][27]. Consequently, several protocols are available to reduce the first occurrence of adverse reactions after systemic administration CM [19,28,29].…”

Section: Prevention Of Adverse Reaction To Con-trast Media Administermentioning

confidence: 99%

Adverse Reactions to Iodinated Contrast Media Administered at the Time of Endoscopic Retrograde Cholangiopancreatography (ERCP)

Pan¹,

Draganov²

2009

IADT

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Adverse reactions after intravascular administration of iodine contrast media are common and prophylactic regiments consisting of the use of steroids and low osmolality contrast media are highly effective in significantly decreasing the adverse reactions rate. The same type of contrast media are also used for opacification of the biliary tree and the pancreatic duct at the time of endoscopic retrograde cholangiopancreatography (ERCP). Systemic absorption of contrast media after ERCP routinely occurs. Although the adverse reaction rate appears to be very low the exact incidence remains unknown due to the retrospective nature of all reports. Despite the lack of formal recommendations, numerous prophylactic regiments are routinely used prior to ERCP in patients with history of prior reaction to intravascular contrast media. Moreover, the use of prophylaxis has even expanded to patients with no prior reaction to intravascular contrast media who are somehow perceived to be at increase risk (e.g. shellfish allergy). Recently, the first large scale prospective study reported exceedingly low incidence of adverse reaction to high oslmolality iodine-containing contrast media administered at the time of ERCP done without prophylactic premedication even in patients considered to be at the highest risk (prior severe reaction to intravascular contrast media administration). These data suggest that the use of prophylactic regiments prior to ERCP appears to be unnecessary.

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“…2,[7][8][9] Anaphylactic deaths have occurred even when the bite of food was spat out and not swallowed or aspirated, 7 and with just a test dose of 1 to 2 mL of radiographic contrast material. 10 Often, in fatalities, epinephrine was not immediately administered. 2,7,8 …”

Section: Introductionmentioning

confidence: 99%

Fatal and Near-fatal Anaphylaxis

Greenberger¹

2015

Immunology and Allergy Clinics of North America

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Prediction of severe adverse reactions to ionic and nonionic contrast media in Japan: evaluation of pretesting. A report from the Japanese Committee on the Safety of Contrast Media.

Cited by 72 publications

References 0 publications

Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations

Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations

Adverse Reactions to Iodinated Contrast Media Administered at the Time of Endoscopic Retrograde Cholangiopancreatography (ERCP)

Fatal and Near-fatal Anaphylaxis

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