Radiocontrast media-associated exanthema: Identification of cross-reactivity and tolerability by allergologic testing

Seitz, Cornelia S.; Pfeuffer, Petra; Raith, Petra; Bröcker, Eva‐B.; Trautmann, Axel

doi:10.1016/j.ejrad.2008.06.010

Cited by 36 publications

(43 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For delayed HSR, one study found successful ICM challenge in four patients with a total dose of 53.5 mL ICM and another study reported a positive ICM challenge (up to 10 −1 of the usual dose) in 5/12 patients with negative skin test results . Torres et al.…”

Section: Discussionmentioning

confidence: 99%

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Sesé

Gaouar

Autegarden

et al. 2016

Clin Experimental Allergy

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Sesé

Gaouar

Autegarden

et al. 2016

Clin Experimental Allergy

View full text Add to dashboard Cite

show abstract

“…Cross-reactivity between ICM is less common in immediate reactions [33] and is related to chemical structure [90]. The association most frequently detected is between iodixanol, iohexol, iopentol, ioversol, and iomeprol.…”

Section: Cross-reactivitymentioning

confidence: 99%

Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media

Rosado¹,

Díaz²,

Moreno³

et al. 2016

J Investig Allergol Clin Immunol

126

124

View full text Add to dashboard Cite

The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. Key words: Iodinated. Gadolinium. Contrast media. Allergy. Hypersensitivity. Anaphylaxis. Immediate reactions. Nonimmediate reactions. PrologueThe objective of these guidelines is to ensure efficient and effective clinical practice in the diagnosis and management of hypersensitivity reactions to radiologic contrast media. The guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) with extensive clinical expertise in the evaluation and management of hypersensitivity reactions and broad research experience.We performed a systematic and independent review of the literature up to November 2015 and established a consensus of expert opinion. We evaluated the applicability of the guidelines in our daily clinical practice. The guidelines were evaluated and criticized by external reviewers with expertise in the field. MethodThe panel of experts who produced this consensus document developed a research protocol outlining the background to the subject of study, the objectives of the study, and the questions and hypotheses from which search criteria were defined.The main sources used for the literature search included electronic databases and archives (MEDLINE-PubMed, Science Direct, OVID) and a database of systematic re...

show abstract

“…Due to the weak level of evidence, certain authors recommend a controlled re-administration of the ICM found to be negative in skin test, under hospital surveillance in order to reassure its tolerability. Seitz et al [48] followed this approach in six out of 32 patients who had proven delayed immunologic mechanism by IDT or patch test to ICM. Two of them demonstrated skin test positivity to all agents tested, whereas in the remaining four, negative skin test results were confirmed by controlled challenges.…”

Section: Iodinated Contrast Mediamentioning

confidence: 98%

Drug provocation tests in hypersensitivity drug reactions

Rerkpattanapipat

Chiriac²,

Demoly³

2011

Current Opinion in Allergy &Amp; Clinical Immunology

View full text Add to dashboard Cite

show abstract

Radiocontrast media-associated exanthema: Identification of cross-reactivity and tolerability by allergologic testing

Cited by 36 publications

References 21 publications

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose

Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media

Drug provocation tests in hypersensitivity drug reactions

Contact Info

Product

Resources

About