Inherent clinical properties of non‐immediate hypersensitivity to iodinated contrast media

2021 ◽  
Author(s):  
Violeta Kvedariene ◽  
Monika Orvydaite ◽  
Paulina Petraityte ◽  
Justina Rudyte ◽  
Algirdas Edvardas Tamosiunas
Keyword(s):  
Contrast Media ◽  
Iodinated Contrast Media ◽  
Immediate Hypersensitivity ◽  
Iodinated Contrast

scholarly journals Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions

2019 ◽  
Vol 6 (4) ◽  
pp. 538-553
Author(s):  
Rik Schrijvers ◽  
Pascal Demoly ◽  
Anca Mirela Chiriac
Keyword(s):  
Contrast Media ◽  
Skin Test ◽  
Diagnostic Delay ◽  
Initial Reaction ◽  
Number Needed To Treat ◽  
Type I ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Immediate Hypersensitivity ◽  
Iodinated Contrast

Abstract Purpose of the review Premedication using antihistamines and/or corticosteroids has been widely used to prevent reoccurrence of immediate hypersensitivity reactions (iHR) after iodinated contrast media (ICM). However, efficacy has been debated, especially in high-risk patients. Novel findings on the role and risks of premedication and preventive strategies are summarized. Recent findings The rate and severity of iHR occurring despite premedication indicate that premedication is not a panacea and the intensity usually reflects that of the initial reaction. Next, the number needed to treat (NNT) to prevent one serious ICM-mediated event using corticosteroid-based premedication is high and associated with a diagnostic delay. Randomly changing the ICM has been suggested as an additional preventive measure, whilst others used a skin test–based approach to identify a subgroup of ICM allergic patients and negative skin test–based alternatives with a high negative predictive value. Summary Growing evidence indicates the need to discriminate between non-allergic iHR that are most likely non-obligatory and susceptible to premedication, and rare type I allergic iHR that can be identified using skin testing, especially in those with a severe iHR. Although premedication reduces reoccurrence of mild iHR, it is not always efficacious and should be balanced against side effects, a high NNT and an uncertain efficacy physicians should not blindly rely on. Future work should evaluate combined approaches of an allergy-driven ICM selection and endotype-driven premedication regimens in patients with non-allergic iHR.

Tolerability of iobitridol in patients with non‐immediate hypersensitivity reactions to iodinated contrast media

Allergy ◽  
2018 ◽  
Vol 74 (1) ◽  
pp. 195-197 ◽  
Author(s):  
Maria Teresa Gracia‐Bara ◽  
Esther Moreno ◽  
Elena Laffond ◽  
Francisco Muñoz‐Bellido ◽  
Milagros Lázaro ◽  
...  
Keyword(s):  
Contrast Media ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Immediate Hypersensitivity ◽  
Iodinated Contrast
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