Reactions to Both Nonionic Iodinated and Gadolinium-Based Contrast Media: Incidence and Clinical Characteristics

Sodagari, Faezeh; Mozaffary, Amirhossein; Wood, Cecil G.; Schmitz, Brenda; Miller, Frank H.; Yaghmai, Vahid

doi:10.2214/ajr.17.18655

Cited by 34 publications

(21 citation statements)

References 25 publications

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“…Sasamura et al reported the use of gadolinium for venography of the adrenal veins in a patient with ICM allergy without any side effects [ 36 ]. A reaction to both ICM and gadolinium is believed to be a rare event [ 37 ] because they are chemically distinct compounds with structural differences. In 1 study, the incidence rate of acute allergic-like reactions to both agents in patients who have received both types of contrast media for imaging studies was reported [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…A reaction to both ICM and gadolinium is believed to be a rare event [ 37 ] because they are chemically distinct compounds with structural differences. In 1 study, the incidence rate of acute allergic-like reactions to both agents in patients who have received both types of contrast media for imaging studies was reported [ 37 ]. The overall incidence rates of reaction to ICM and gadolinium were 0.48% and 0.17%, respectively; 0.024% of patients had reactions to both ICM and gadolinium.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Adrenal Vein Sampling in a Patient With Primary Hyperaldosteronism and Severe Contrast Allergy

Prins

Ballieux

Meijer

et al. 2021

Journal of the Endocrine Society

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We report on a case of a 50-year-old female patient with primary hyperaldosteronism, in whom adrenal venous sampling was required to differentiate between unilateral and bilateral disease. Because of a history of severe allergy to iodinated contrast media, premedication with glucocorticoids was indicated. Exogenous glucocorticoids, however, can affect measurements of serum cortisol. To avoid this potential confounding effects on the cortisol assay, we decided to use dexamethasone instead of prednisolone or hydrocortisone. A high-dose ACTH stimulation test with the simultaneous use of dexamethasone revealed an adequate adrenal cortisol response. ACTH-stimulated adrenal venous sampling showed reliable results, which provided a solid basis for further clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Adrenal Vein Sampling in a Patient With Primary Hyperaldosteronism and Severe Contrast Allergy

Prins

Ballieux

Meijer

et al. 2021

Journal of the Endocrine Society

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“…Immediate hypersensitivity reactions to contrast media are defined as an allergic reaction that occurs within 30 min of contrast media administration. Delayed hypersensitivity reactions to contrast media are defined as reactions that appear between 1 h and 7 days after administration of the contrast agent (6).…”

Section: Methodsmentioning

confidence: 99%

“…Their administration is not totally safe, the adverse effects of the contrast media may be due to the type of administration, or to the type of agent used. The most common side effects after parenteral administration of contrast media are organ toxicity (with kidney being the most affected organ) (5) and hypersensitivity reactions (6).…”

Section: Introductionmentioning

confidence: 99%

The incidence of skin lesions in contrast media-induced chemical hypersensitivity

et al. 2018

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Contrast agents are used in radiology to increase the sensibility and specificity of radiological techniques. Some of these compounds have side effects that include organ toxicity (with kidney being the most affected organ) and hypersensitivity reactions. We performed multiple PubMed searches from January, 2008 to January, 2018 for studies regarding adverse reactions to compounds used as contrast agents in imagistic techniques. The initial research identified 929 records written in English. After further excluding 223 non-human studies, 292 articles that had irrelevant designs as reviews, meta-analysis, commentaries, editorials and case reports, 414 studies were selected for retrieval. After reading the abstracts, we excluded 363 studies as they had little relevance to the study. In total, 51 full-articles were assessed for eligible studies to be included. Finally, 20 articles were included in the analysis. In our systematic literature search the incidence of overall skin immediate reactions to iodinated contrast media (ICM) had an incidence between 1.15 and 0.12%, depending on the cohort analyzed in the studies. The percentage of cutaneous manifestations in the cohort that experienced immediate hypersensitivity reactions was between 33.33 and 87.7%. The most frequent skin manifestations were urticaria, rashes, pruritus and limited facial edema. Non-iodinated contrast agents have a safer profile compared with ICM, the incidence of immediate adverse reactions being very low in gadolinium-based contrast agents and other agents used for contrast-enhanced ultrasound. The incidence of delayed reactions was between 10.1 and 0.03%. In the studies analyzed by us the main adverse reactions due to delayed hypersensitivity phenomena were cutaneous manifestations that were present between 70.27 and 100% of the cases. Regarding the risk factors for developing immediate adverse reactions, being female was a predisposing factor accompanied by history of allergy and history of reactions to contrast media. An accurate anamnesis of the patients and a correctly conducted pretreatment can limit the incidence and the severity of the adverse reactions and also can avoid the life occurrence of life-threatening reactions.

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“…The most common side effects after parenteral administration of CM apart from organ toxicity (with kidney being the most affected organ) [14] are hypersensitivity reactions [15]. Local side effects are attributed to extravasation but administration typically involves small volumes, and therefore it rarely results in serious injuries.…”

Section: Introductionmentioning

confidence: 99%

Contrast-induced nephropathy in an animal model: Evaluation of novel biomarkers in blood and tissue samples

et al. 2019

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Reactions to Both Nonionic Iodinated and Gadolinium-Based Contrast Media: Incidence and Clinical Characteristics

Abstract: An allergiclike reaction to both nonionic ICM and GBCM was an extremely rare event that presented as a mild acute reaction without significant clinical consequences despite the fact that an allergy preparation was not administered.

Cited by 34 publications

References 25 publications

Adrenal Vein Sampling in a Patient With Primary Hyperaldosteronism and Severe Contrast Allergy

Adrenal Vein Sampling in a Patient With Primary Hyperaldosteronism and Severe Contrast Allergy

The incidence of skin lesions in contrast media-induced chemical hypersensitivity

Contrast-induced nephropathy in an animal model: Evaluation of novel biomarkers in blood and tissue samples

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