Clinical Features and Treatment Patterns of Radiocontrast Mediainduced Anaphylaxis in the Emergency Department.
- Author:
Hahn Bom KIM
1
;
Do Kyun KIM
Author Information
1. Department of Emergency Medicine, College of Medicine, Seoul National University, Seoul, Korea. birdbeak@naver.com
- Publication Type:Original Article
- Keywords:
Contrast media;
Anaphylaxis;
Epinephrine
- MeSH:
Adrenal Cortex Hormones;
Anaphylaxis;
Angioedema;
Blood Pressure;
Contrast Media;
Dizziness;
Dyspnea;
Emergencies;
Epinephrine;
Humans;
Korea;
Male;
Medical Records;
Radiology, Interventional;
Referral and Consultation;
Retrospective Studies;
Syncope
- From:Journal of the Korean Society of Emergency Medicine
2009;20(6):709-714
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: With the advances in diagnostic and interventional radiology, emergency physicians have been frequently confronted with radiocontrast media (RCM)-induced anaphylaxis. However, few studies have addresses RCMinduced anaphylaxis in Korea. The aim of this study was to describe the clinical features and treatment patterns of RCM-induced anaphylaxis patients who visited an emergency department (ED) in a tertiary referral hospital. METHODS: All patients who visited the ED and were diagnosed with "anaphylaxis" during a 3-year period were evaluated and cases of RCM-induced anaphylaxis were selected based on medical records. RESULTS: Twenty patients with RCM-induced anaphylaxis were retrospectively analyzed. Nine patients (45.0%) were male and the mean age was 59.5+/-14.9 years. Eighteen patients were referred following computed tomography (CT) examination and 2 patients from home. The most common manifestations were systolic blood pressure (SBP) < 90 mmHg (75.0%), followed by dizziness (55.0%), syncope (40.0%), angioedema (35.0%), and dyspnea (35.0%). Epinephrine was administered in 16 patients (80.0%), corticosteroids in 18 (90.0%), and antihistamine in 18 (90.0%). Only 4 patients (22.2%) were managed by epinephrine in the CT room. Seventeen patients were discharged directly from the ED after some observation period (7.3+/-5.0 hours) and 3 were admitted to the ICU. Corticosteroids were prescribed at discharge only in 9 patients (45.0%). CONCLUSION: The clinical features of RCM-induced anaphylaxis were similar to those of other causative agents. The underuse of epinephrine in the CT room and the under-prescription of corticosteroids at discharge indicate a need for anaphylaxis management education and treatment plan.
