Immediate and delayed reactions to radiocontrast media: is there an allergic mechanism?
Radiocontrast media can cause immediate (1 hour) and nonimmediate (>1 hour) hypersensitivity reactions that remain unpredictable and a cause of concern for radiologists and cardiologists. Immediate hypersensitivity reactions resemble anaphylaxis, whereas nonimmediate ones clinically are predominated by exanthemas. Increasing evidence indicates that immediate reactions and nonimmediate skin exanthemas may be allergic reactions involving either contrast media-reactive IgE or T cells, respectively. Skin testing is a useful tool for the diagnosis of contrast media allergy. It may have an important role in the selection of a safe product in previous reactors, although validation data are still lacking. In vitro tests to search for contrast media-specific cell activation are currently under investigation.
Brockow
Knut
K
Department of Dermatology and Allergy Biederstein, Technische Universität München, Biedersteiner Strasse 29, Munich 80802, Germany. knut.brockow@lrz.tum.de
D000818:Animals; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology*; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology*; D016273:Occupational Exposure; D017410:Practice Guidelines as Topic; D011859:Radiography; D012882:Skin Tests
D003287:Contrast Media