Radiocontrast media-induced acute generalized exanthematous pustulosis: A safe administration of alternative radiocontrast media using patch tests.
10.4168/aard.2018.6.5.270
- Author:
Sun Hyung KIM
1
;
Seung Youn LEE
;
Young Hee CHOI
;
Cheol Hong KIM
;
In Kyu HYUN
;
Jeong Hee CHOI
Author Information
1. Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. mdqueen@hallym.or.kr
- Publication Type:Case Report
- Keywords:
Radiocontrast media;
Acute generalized exanthematous pustulosis;
Skin test
- MeSH:
Acute Generalized Exanthematous Pustulosis*;
Adult;
Angiography;
Contrast Media*;
Coronary Vessels;
Diagnosis;
Female;
Humans;
Hypersensitivity;
Intradermal Tests;
Iohexol;
Iopamidol;
Kidney Failure, Chronic;
Myocardial Ischemia;
Patch Tests*;
Renal Dialysis;
Skin Tests
- From:Allergy, Asthma & Respiratory Disease
2018;6(5):270-273
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Acute generalized exanthematous pustulosis (AGEP) is rarely caused by radiocontrast media (RCM). The role of skin tests for the diagnosis and evaluation of cross-reactivity in a delayed type of RCM-induced hypersensitivity have yet to be determined. Here, we report a case of iodixanol-induced AGEP where we safely administered alternative RCM using patch tests. A 44-year-old woman had coronary artery angiography (CAG) for the evaluation of ischemic heart disease. She was on regular hemodialysis because of end-stage renal disease. She was given iodixanol (Visipaque) during CAG. Approximately 1 day after CAG, she developed AGEP. The patient was rehospitalized for CAG again after 1 year. We performed skin tests to choose safe alternative RCM. Intradermal tests with iodixanol, iohexol (Bonorex) and Iopamidol (Pamiray) showed negative responses. Patch tests showed a positive response to iodixanol, equivocal to iohexol, and negative to Iopamidol. We finally chose Iopamidol and performed CAG successfully without any adverse reaction. Patch tests may be a useful tool for the diagnosis and choice of safe alternatives in RCM-induced delayed-type hypersensitivity reactions such as AGEP.
