Objective assessment of immediate iodine-based contrast media hypersensitivity reactions using skin and drug provocation testing.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Si Min Chiow, Pearlyn Mei Ping Wong, Martin Weng Chin H'ng, Chau Hung Lee, Sze-Chin Tan
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Abstract

BackgroundWith increasing importance of iodine-based contrast media (ICM) in radiology, a label of allergy to ICM has significant impact on patient management, and objective testing for ICM allergy can help guide subsequent administration.PurposeTo correlate skin testing with drug provocation test (DPT) outcomes and determine cross-reactivity between our institution's three available ICMs.Material and MethodsEligible patients who presented to our institution's radiology department within a 3-year period with suspected ICM allergy were referred to the allergist for evaluation with skin testing ± DPT. Patients who tested negative were followed up to evaluate for any reaction after ICM re-exposure in subsequent contrast-enhanced computed tomography scans.ResultsA total of 72 cases underwent testing. Concordance between skin testing and DPT was 85.7% (6/7) for iohexol, 65.1% (28/43) for iodixanol, and 100% (2/2) for iopromide. Cross-reactivity was in the range of 59.6%-75.9% between iohexol and iodixanol, 75.0%-77.4% between iohexol and iopromide, and 43.3%-60.0% between iodixanol and iopromide. Only 1/14 patients who were skin test and DPT negative developed a reaction on re-exposure to ICM after testing.ConclusionObjective testing for ICM hypersensitivity, particularly within 6 months of initial exposure, allows the majority of patients to be administered the same or an alternative ICM with no adverse reaction, with iodixanol having the lowest cross-reactivity.

用皮肤和药物激发试验客观评价即时碘造影剂超敏反应。
背景:随着碘基造影剂(ICM)在放射学中的重要性日益增加,ICM过敏标签对患者管理具有重要影响,ICM过敏的客观检测可以帮助指导后续的给药。目的将皮肤试验与药物激发试验(DPT)结果相关联,并确定我院现有三种ICMs之间的交叉反应性。材料与方法3年内就诊于我院放射科疑似ICM过敏的合格患者,交由过敏专科医师进行皮肤试验±DPT评估。对检测结果为阴性的患者进行随访,以评估ICM再次暴露后在随后的增强计算机断层扫描中的任何反应。结果共检测72例。皮肤试验与DPT的符合率分别为:碘己醇85.7%(6/7)、碘二沙醇65.1%(28/43)、碘丙啶100%(2/2)。碘己醇与碘二醇的交叉反应性为59.6% ~ 75.9%,碘己醇与碘丙烯的交叉反应性为75.0% ~ 77.4%,碘二醇与碘丙烯的交叉反应性为43.3% ~ 60.0%。皮肤试验和DPT阴性的患者中,只有1/14的患者在试验后再次暴露于ICM后发生反应。结论:ICM超敏反应的客观检测,特别是首次接触ICM 6个月内,允许大多数患者使用相同或替代ICM而无不良反应,其中碘沙醇具有最低的交叉反应性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
期刊介绍: Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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