Allergic reactions following contrast material administration: nomenclature, classification, and mechanisms.
In forensic pathology routine, fatal cases of contrast agent exposure can be occasionally encountered. In such situations, beyond the difficulties inherent in establishing the cause of death due to nonspecific or absent autopsy and histology findings as well as limited laboratory investigations, pathologists may face other problems in formulating exhaustive, complete reports, and conclusions that are scientifically accurate. Indeed, terminology concerning adverse drug reactions and allergy nomenclature is confusing. Some terms, still utilized in forensic and radiological reports, are outdated and should be avoided. Additionally, not all forensic pathologists master contrast material classification and pathogenesis of contrast agent reactions. We present a review of the literature covering allergic reactions to contrast material exposure in order to update used terminology, explain the pathophysiology, and list currently available laboratory investigations for diagnosis in the forensic setting.
University Centre of Legal Medicine, Rue du Bugnon 21, 1011, Lausanne, Switzerland, cristian.palmiere@chuv.ch.
Cristian
C
Palmiere
Lionel
L
Comment
Patrice
P
Mangin
D000707:Anaphylaxis / Q000145:classification / Q000276:immunology / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage / Q000145:classification / Q000633:toxicity*; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000145:classification* / Q000276:immunology / Q000473:pathology*; D006632:Histamine / Q000097:blood; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood; D008407:Mast Cells / Q000187:drug effects / Q000276:immunology; D011180:Postmortem Changes; D009626:Terminology as Topic; D053802:Tryptases / Q000097:blood
D003287:Contrast Media; D007073:Immunoglobulin E; D006632:Histamine; D053802:Tryptases