There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. Even by allergic reactions, it was assumed that 80% of them might be caused by antiseptic agents such as paraben. In addition, it was suggested that ALAs, especially lidocaine hydrochloride preparations have high antigenicity (sensitizing property). Furthermore, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.

Increased CXCL8 levels produced by beta-lactams administration were accompanied by LMIA. CXCL8 may be involved in LMIA and play a role in beta-lactam allergies. In contrast, the LMIA detected in patients with allergies to APAs may be a cytokine or chemokine other than CXCL8.

In vivo tests may be used for the diagnosis of allergy to iodinated contrast media (ICM); however, the tests do not provide definitive diagnosis and are associated with risks for patients. Diagnoses based on in vitro tests are limited, and there are almost no relevant studies. Herein, the authors examined involvement of allergic reaction from a multilateral standpoint in 39 patients suspected of having ICM allergies using leukocyte migration test (LMT). The positive rate of LMT was 44%. A comparison with the positive rate of LMT in drugs other than ICM (74%) indicated 30% difference, which was significantly low value, suggesting that there is poor involvement of these drugs in the allergic reaction. In LMT positives, 76% of hypersensitivity reactions were skin rash mainly erythema, and 18% was anaphylactic reactions. Cases considered as non-immediate hypersensitivity accounted for about 4 times as many as immediate-type hypersensitivity. In examination of relevancy between a history of drugs or food allergies, the incidence of ICM allergies was 35%. There is a high possibility that these adverse reactions were caused by pseudoallergy to drug. It was suggested that most hypersensitivity reactions were skin rash related to non-immediate hypersensitivity, and approximately 20% of the reaction was immediate anaphylactic reaction. Therefore attention should be paid not only to immediate-type hypersensitivity but also delayed reactions. Moreover, it was considered that patients with past history of drug or food allergies have a high potential for manifestation of the reactions.Key words iodinated contrast media (ICM); leukocyte migration test (LMT); pseudoallergy; non-immediate hypersensitivity; allergic history Since the late 1980 s, a number of hypoosmotic, nonionic iodinated contrast media (ICM) have been used instead of ionic ICM. To meet this trend, development of serious adverse effects, such as pain, sensations of burning and anaphylactoid symptoms at the time of high-pressure injection, reduced significantly. On the other hand, allergic side effects caused by nonionic ICM became to attract attention, and not only immediate type hypersensitivity cases, which have a high severity, but also delayed hypersensitivity cases have been reported. [1][2][3][4][5] However, test methods used when ICM allergy is suspected are in vivo identification tests including patch test, intracutaneous reaction test, prick test and scratch test. As in vitro identification tests, radio-allergo-solvent test (RAST) using specific immunoglobulin E (IgE) antibody, histamine release test (HRT), basophil activation test (BAT) and drug-induced lymphocyte stimulation test (DLST) may be conducted. DLST are often used in clinical practice; however, clinical utility in the diagnosis of ICM allergy is not proved yet because of its low detection sensitivity. In other words, there is almost no research analysis that used in vitro identification methods for multiple cases to identify ICM allergy, and proved its utility.Authors have reported that leuk...

No abstract