The Potential Utility of Iodinated Contrast Media (ICM) Skin Testing in Patients with ICM Hypersensitivity.
10.3346/jkms.2015.30.3.245
- Author:
Young Hwan AHN
1
;
Young Il KOH
;
Joo Hee KIM
;
Ga Young BAN
;
Yeon Kyung LEE
;
Ga Na HONG
;
U Ram JIN
;
Byung Joo CHOI
;
Yoo Seob SHIN
;
Hae Sim PARK
;
Young Min YE
Author Information
1. Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea. ye9007@ajou.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Contrast Media;
Hypersensitivity;
Skin Tests;
Anaphylaxis
- MeSH:
Anaphylaxis/chemically induced/diagnosis/immunology;
Contrast Media/*adverse effects;
Cross Reactions/immunology;
Dermatitis, Contact/*diagnosis/*immunology;
Drug Hypersensitivity/diagnosis;
Female;
Humans;
Iodides/*immunology;
Iohexol/analogs & derivatives;
Iopamidol/analogs & derivatives;
Male;
Middle Aged;
Republic of Korea;
Skin Tests/*methods;
Triiodobenzoic Acids;
Urticaria/diagnosis/immunology
- From:Journal of Korean Medical Science
2015;30(3):245-251
- CountryRepublic of Korea
- Language:English
-
Abstract:
Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.
