title: Increased incidence of hypersensitivity to iodine-containing radiographic contrast media after interleukin-2 administration.
abstract: Eight of 28 (28%) cancer patients with liver metastases treated by either splenic (four) or hepatic (four) arterial infusion of recombinant interleukin-2 (rIL-2) developed hypersensitivity reactions to iodine-containing radiographic contrast media. These reactions consisted of fever, chills, malaise, nausea and vomiting, skin rash, diarrhea, and occasionally, hypotension. Reactions usually occurred 1 month after the initial arteriographic procedure and rIL-2 infusion, with 1-hour to 4-hour intervals between procedure and reexposure of the patient to the iodine-containing contrast medium (used in conjunction with computerized tomography or repeated arteriography for subsequent courses of rIL-2 infusions) and the onset of symptoms. Prompt administration of corticosteroids during the reaction and premedication of patients who were known to have had a reaction in the past were very effective in stopping reactions or preventing them from reoccurring. The high incidence (28%) of hypersensitivity reactions, the temporal relationship (4 hours) between the arteriographic procedure (utilizing iodine-containing contrast medium) and the initial infusion of rIL-2 (while some of the contrast medium was still present), and the absence of such hypersensitivity reactions among patients receiving systemic (intravenous) rIL-2 (not requiring the use of concomitant iodine-containing contrast medium) provide additional evidence that in the presence of a potentially immunogenic moiety, rIL-2, a potent stimulant of the human immune system, can produce an initial sensitization followed by subsequent anamnestic reaction upon reexposure of the patient to the immunogen (even without the additional rIL-2).
authors.affiliation: Department of Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
authors.forename: A A
authors.initials: AA
authors.lastname: Zukiwski
authors.forename: C L
authors.initials: CL
authors.lastname: David
authors.forename: J
authors.initials: J
authors.lastname: Coan
authors.forename: S
authors.initials: S
authors.lastname: Wallace
authors.forename: J U
authors.initials: JU
authors.lastname: Gutterman
authors.forename: G M
authors.initials: GM
authors.lastname: Mavligit
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007376:Interleukin-2 / Q000009:adverse effects*; D007455:Iodine / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007376:Interleukin-2; D007455:Iodine