Int J Clin Pract. 2021 Sep 2:e14766. doi: 10.1111/ijcp.14766. Online ahead of print.
ABSTRACT
BACKGROUND: Iodinated contrast media (ICM) – frequently used compound in radiology. Non-immediate hypersensitivity reactions (HSR) appear when a patient leaves the department and usually are undocumented. True hypersensitivity in this group is rarely proved.
METHODS: Single-center 2014-2018 data was retrospectively analysed. HSR to ICM were classified and investigated according to the time of occurrence (immediate <1h, non-immediate >1h). ENDA questionnaire and skin tests (prick or intradermal test) were performed according to ENDA/EAACI recommendations.
RESULTS: 69 patients with a clinical history of HSR to ICM were identified, 72.46% were females (n=50). Average age was 56 (SD ± 13.16) years. Non-immediate HSR occurred in 28.99% (n=20) patients. The suspected culprit drugs were: iodixanol 20% (n=4), iopromide 5% (n=1), diatrizoate 10% (n=2), iohexol 10% (n=2). Among non-immediate HSR 96.00% (n=19) of patients had skin rashes. A statistically significant correlation was found between the clinical symptoms and the type of reaction (p-value < 0,05): isolated skin manifestations mostly occurred in non-immediate HSR 75.00% (n=15). Only 13.04% (n=9) of all the patients were proved to be allergic to a certain ICM after the proposed diagnostic workup.
CONCLUSIONS: One third of the hypersensitivity reactions investigated were classified as non-immediate type. Most of them manifested with isolated skin symptoms. The most frequent culprit drug encountered was iodixanol. The overall non-immediate hypersensitivity confirmation rate after diagnostic evaluation was only 15%.
PMID:34473887 | DOI:10.1111/ijcp.14766
