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

Gallardo-Higueras, A; Moreno, EM; Muñoz-Bellido, Francisco J.; Laffond, Elena; Bara, María Teresa Gracia; Macías, Eva; Campanón, M. Valle; Arriba, Sonia de; Martin, C.; Sobrino, Miriam; Dávila, Ignacio

doi:10.18176/jiaci.0694

Cited by 5 publications

(14 citation statements)

References 11 publications

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“…Nineteen articles that evaluated immediate reactions and performed an allergy evaluation were found in the bibliographic search ( 3 , 7 , 13 – 29 ). Most of them were isolated cases or small series of cases ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…In IHRs, in most articles, skin prick tests (SPTs) with undiluted commercial solutions and intradermal tests (IDTs) diluted at 1:10 were generally used ( 3 , 17 , 19 , 25 , 29 ), actual concentrations were not mentioned in the articles. In the case of severe reactions, IDTs began with higher dilutions ( 35 ).…”

Section: Resultsmentioning

confidence: 99%

“…That is an omission that has to be remarked in this review. STs were performed with the GBCAs involved in the reaction if known, although some authors recommend using a panel of GBCAs ( 28 , 29 ).…”

Section: Resultsmentioning

confidence: 99%

“…In some studies, when STs were negative, controlled provocation tests were performed ( 3 , 7 , 18 , 19 , 21 , 22 , 25 – 27 , 29 , 34 , 36 ). There are very few articles specifying the doses and schedules used for DPTs.…”

Section: Resultsmentioning

confidence: 99%

“…Generally speaking, we found no consensus regarding total doses or intervals. Doses for DPTS ranged from 1 to 10 mL ( 3 , 29 , 36 ), with increasing doses at 1-h intervals ( 29 , 36 ). In some of them, patients tolerated another GBCA than those they were sensitized to ( 3 , 7 , 18 , 21 , 26 , 27 , 29 , 36 ).…”

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%