First case report of acute generalized exanthematous pustulosis (<scp>AGEP</scp>) caused by gadolinium confirmed by patch testing

Gómez, Mauricio Rojas; García, Camino López; Yebra, Carmen Meseguer; Cobo, Michael; Alvarez, M.; Estella, Juan Sánchez

doi:10.1111/cod.12878

Cited by 18 publications

(10 citation statements)

References 9 publications

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“… * Positivity criteria according to ENDA's guidelines . The rest of the studies do not specify the positivity criteria, except ( 30 ) that follows the Contact Dermatitis Research Group Scoring system recommendations and ( 31 ) that follow the European Society of Contact Dermatitis recommendations .…”

Section: Resultsmentioning

confidence: 99%

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Hypersensitivity to Gadolinium-Based Contrast Media

et al. 2022

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Gadolinium-based contrast agents (GBCAs) are frequently used in magnetic resonance imaging (MRI) examinations to increase sensitivity in diagnoses. Recently, an increase in the description of hypersensitivity reactions to GBCAs has been detected. We performed research in PubMed, PubMed, SCOPUS, and EMBASE until September 2021, searching for studies regarding immediate and delayed hypersensitivity reactions to gadolinium-based contrast agents in which an allergy study was performed. The initial research identified 149 articles written in English. After excluding articles duplicated and articles that had irrelevant designs, 26 articles were included. Finally, 17 studies concerning immediate reactions, six studies concerning non-immediate reactions, and three concerning both that performed allergy evaluations were selected. In the review, we analyzed the characteristics of immediate and delayed reactions and the results of the allergy study and cross-reactivity. Skin tests seem to have acceptable accuracy, but drug provocation tests are still needed when skin tests are negative o to find alternative agents. Although cross-reactivity patterns are not well established, cross-reactivity seems to exist among macrocyclic agents. Notwithstanding, the number of patients analyzed is low and further studies are required. A management algorithm is suggested.

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Section: Resultsmentioning

confidence: 99%

“…One case ( 31 ) involved an acute generalized exanthematous pustulosis (AGEP) due to gadobutrol, with PTs yielding positive results to gadobutrol on days 2 and 4 and negative results to gadoterate meglumine. DPTs were not performed.…”

Section: Discussionmentioning

confidence: 99%

Hypersensitivity to Gadolinium-Based Contrast Media

et al. 2022

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“…Indeed, the patient received several drugs in addition to gadobutrol and no allergy work-up were performed. The same year, a case of acute generalized exanthematous pustulosis (AGEP) following GBCA injection was also described [8]. In this case, the injected GBCA was unknown.…”

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confidence: 83%

Nonimmediate Maculopapular Erythema Induced by a Gadolinium-Based Contrast Agent

Gauthier¹,

Mankouri²,

Demoly³

et al. 2022

J Investig Allergol Clin Immunol

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“…19 Nonimmediate hypersensitivity reactions to GBCM are extremely rare, but AGEP has been reported. 20 An important nonallergic late reaction to GBCM, especially in patients with impaired kidney function, is nephrogenic systemic fibrosis, which causes fibrosis mostly of the skin and subcutaneous tissues. However, internal organs, skeletal muscles, and joints can be involved, and fatalities have been reported.…”

Section: Clinical Findings In Nihrmentioning

confidence: 99%

Adverse reactions during procedures

Schönmann

Brockow

2020

Annals of Allergy, Asthma & Immunology

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Incidences of hypersensitivity reactions to contrast media and dyes are low, but because of their frequent use, the absolute number of hypersensitivity reactions is relevant and represents a clinical problem in allergology. Hypersensitivity reactions can be divided into 2 groups: immediate hypersensitivity (urticaria/angioedema/anaphylaxis) and nonimmediate hypersensitivity reactions (exanthems). Allergological workup (skin tests AE laboratory tests) is helpful to confirm an allergic mechanism and in those in whom the culprit is positive also to select skin test-negative alternatives for future procedures. For patients needing urgent re-administration without the possibility of allergological workup, the decision on avoidance of contrast media or readministration of one other than the culprit agent with premedication and emergency preparedness is based on the severity of the initial reaction. Provocation tests in an allergy department under emergency preparedness may be considered to confirm tolerance to an alternative contrast medium for readministration.

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First case report of acute generalized exanthematous pustulosis (AGEP) caused by gadolinium confirmed by patch testing

Cited by 18 publications

References 9 publications

Hypersensitivity to Gadolinium-Based Contrast Media

Hypersensitivity to Gadolinium-Based Contrast Media

Nonimmediate Maculopapular Erythema Induced by a Gadolinium-Based Contrast Agent

Adverse reactions during procedures

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