Prescreening skin test effectiveness in predicting hypersensitivity to iodinated contrast media
10.5124/jkma.2020.63.3.155
- Author:
Tae Bum KIM
1
Author Information
1. Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tbkim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Computed tomography;
Contrast media;
Skin tests;
Hypersensitivity;
Predictive value of tests
- MeSH:
Contrast Media;
Humans;
Hypersensitivity;
Predictive Value of Tests;
Prospective Studies;
Skin Tests;
Skin;
Tomography, X-Ray Computed
- From:Journal of the Korean Medical Association
2020;63(3):155-158
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hypersensitivity reaction to iodinated contrast media (ICM) is a persistent clinical issue owing to widespread use of computed tomography (CT) examinations. The question of whether routine performance of skin tests can predict hypersensitivity reactions to contrast media remains unresolved. Recently, a prospective study was performed to evaluate the role of an intradermal skin test as a prescreening test for hypersensitivity reactions to ICM. Fifteen (0.5%) of the 2,843 patients had positive skin test results prior to scheduled CT scans. However, none of the patients experienced a hypersensitivity reaction after administration of full-dose ICM. Meanwhile, 19 patients who experienced hypersensitivity reactions to an ICM challenge showed negative skin test results. The sensitivity and positive predictive value of skin tests for hypersensitivity reaction to ICM were both 0%. More studies should be conducted to confirm the uselessness of prescreening skin tests. In conclusion, a prescreening intradermal skin test prior to a CT scan has no significant clinical value as a tool for predicting hypersensitivity reactions to ICM. Therefore, prescreening skin tests should not be routinely performed.
