Abstract
Background: Iodinated contrast media (ICM) are responsible for multiple side effects, especially hypersensitivity reactions. These reactions can either be authentic allergies or non-allergic hypersensitivity reactions. Skin tests (prick and intradermal tests) are simple to perform and can be of great help, especially if the ICM needs to be re-used. The aim of the study was to assess the characteristics of the patients in whom skin tests were performed and the results of these tests.
Methods: This is a retrospective study from June 2014 to June 2019. All included patients had at least one episode of hypersensitivity reaction to ICM and underwent skin tests.
Results: We included 35 patients aged 18 to 85 years. The iopromide was the most implicated ICM. The reactions were mainly cutaneous (n=30) and immediate (n=27). The skin tests were negative, except for two patients. The re-use of ICM occurred in 11 patients: 9 with an ICM other than the one suspected and two patients with the same ICM. Among these patients, 5 did not have any premedication. Two of them had a second hypersensitivity reaction, the first with another ICM and the second with the same ICM.
Conclusion: One of the main pillars of allergic exploration is ICM skin testing, not only to prevent a recurrence, but also to allow patients to benefit from ICM re-use, which are sometimes essential.
Keywords: Iodinated contrast media, drug hypersensitivity, skin tests, in vivo tests, intradermal tests, prick tests.
[http://dx.doi.org/10.1016/j.reval.2015.01.039]
[http://dx.doi.org/10.1016/j.tox.2004.12.032] [PMID: 15767034]
[http://dx.doi.org/10.1148/radiol.2393050560] [PMID: 16720865]
[http://dx.doi.org/10.1016/j.therap.2016.02.009] [PMID: 27080836]
[http://dx.doi.org/10.1016/S0140-6736(77)91953-5] [PMID: 65572]
[PMID: 11991289]
[http://dx.doi.org/10.1148/radiology.175.3.2343107] [PMID: 2343107]
[http://dx.doi.org/10.1007/s000110050395] [PMID: 10350157]
[http://dx.doi.org/10.1007/s00330-002-1650-5] [PMID: 12541128]
[http://dx.doi.org/10.1016/j.carj.2016.05.006] [PMID: 27745988]
[http://dx.doi.org/10.1148/radiology.183.1.1549655] [PMID: 1549655]
[http://dx.doi.org/10.2214/ajr.156.4.1825900] [PMID: 1825900]
[http://dx.doi.org/10.1159/000320760] [PMID: 21293150]
[http://dx.doi.org/10.3346/jkms.2013.28.12.1703] [PMID: 24339697]
[http://dx.doi.org/10.1111/all.12589] [PMID: 25649510]
[PMID: 16689179]
[http://dx.doi.org/10.1016/j.jaip.2017.10.040] [PMID: 29371073]
[http://dx.doi.org/10.1111/j.1398-9995.2008.01832.x] [PMID: 19178403]
[http://dx.doi.org/10.1136/bmj.38905.634132.AE] [PMID: 16880193]