title: Clinical value of radiocontrast media skin tests as a prescreening and diagnostic tool in hypersensitivity reactions.
abstract: BACKGROUND
  Some radiocontrast media (RCM) hypersensitivity reactions may have underlying IgE- or T-cell-mediated mechanisms. RCM skin testing may be useful for predicting future reactions.
  
  
  OBJECTIVE
  To investigate the clinical value of RCM skin testing before computed tomography and after RCM hypersensitivity reactions.
  
  
  METHODS
  Patients who underwent RCM skin testing were a prospective sample of convenience at a single medical center and were tested just before their pending nonionic RCM-enhanced computed tomogram. In addition, skin test data of patients who were referred to the allergy clinic because of their previous RCM hypersensitivity reactions were reviewed retrospectively.
  
  
  RESULTS
  A total of 1048 patients enrolled in the study prospectively. Of these, 672 (64.1%) had never been exposed to RCM. Of the 376 previously exposed to RCM, 61 (16.2%) had a history of at least one mild RCM-associated reaction, 56 (91.8%) had immediate reactions, and 5 had no-immediate reactions. There was only 1 positive immediate hypersensitivity RCM skin test result (0.09%). There were 51 mild immediate reactions (4.9%), 1 moderate immediate reaction (0.09%), 8 mild nonimmediate reactions (0.76%), and 1 moderate nonimmediate reaction (0.09%). There was only 1 positive delayed hypersensitivity skin test result (0.09%), retrospectively determined, in 1 (11.1%) of the nonimmediate RCM-associated reactions. Sensitivity of RCM skin testing was significantly higher with severe immediate reactions (57.1%) than mild reactions (12.9%) and moderate reactions (25.0%) in the retrospective review of diagnostic skin test data (P = .03).
  
  
  CONCLUSIONS
  RCM skin testing for screening is of no clinical utility in predicting hypersensitivity reactions. RCM skin testing may have modest utility in retrospectively evaluating severe adverse reactions.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: Sae-Hoon
authors.initials: SH
authors.lastname: Kim
authors.forename: Eun-Jung
authors.initials: EJ
authors.lastname: Jo
authors.forename: Mi-Yeong
authors.initials: MY
authors.lastname: Kim
authors.forename: Seung-Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Min-Hye
authors.initials: MH
authors.lastname: Kim
authors.forename: Min-Suk
authors.initials: MS
authors.lastname: Yang
authors.forename: Woo-Jung
authors.initials: WJ
authors.lastname: Song
authors.forename: Sang-Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Jae-Hyoung
authors.initials: JH
authors.lastname: Kim
authors.forename: Yoon-Seok
authors.initials: YS
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012882:Skin Tests
chemical_list: D003287:Contrast Media