The potential utility of iodinated contrast media (ICM) skin testing in patients with ICM hypersensitivity.
Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM) are relatively common. However, there are few data to determine the clinical utility of immunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients with ICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolled from 3 university hospitals in Korea. With 6 commonly used ICM including iopromide, iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) and patch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%) were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients with urticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Three of 6 patients with delayed rashes had positive response to patch test and/or delayed IDT. Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequent radiological examinations, 3 patients administered safe alternatives according to the results of skin testing had no adverse reaction. However, anaphylaxis developed in the other 2 patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of the sensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayed hypersensitivity reactions, the present study suggests that skin tests is useful for the diagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence of anaphylaxis caused by the same ICM.
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Young-Hwan
0000-0001-9920-1846
YH
Ahn
Department of Allergy, Asthma and Clinical Immunology, Chonnam National University Medical School, Gwangju, Korea.
Young-Il
0000-0002-5100-9473
YI
Koh
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Joo-Hee
0000-0002-1572-5149
JH
Kim
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Ga-Young
0000-0002-7961-742X
GY
Ban
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Yeon-Kyung
0000-0002-1648-8376
YK
Lee
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Ga-Na
0000-0002-7471-2364
GN
Hong
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
U-Ram
UR
Jin
Department of Cardiology, Ajou University School of Medicine, Suwon, Korea.
Byung-Joo
0000-0002-3045-5343
BJ
Choi
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Yoo-Seob
0000-0002-9855-3185
YS
Shin
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Hae-Sim
0000-0003-2614-0303
HS
Park
Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
Young-Min
0000-0002-7517-1715
YM
Ye
D000707:Anaphylaxis / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology; D003287:Contrast Media / Q000009:adverse effects*; D003429:Cross Reactions / Q000276:immunology; D003877:Dermatitis, Contact / Q000175:diagnosis* / Q000276:immunology*; D004342:Drug Hypersensitivity / Q000175:diagnosis; D005260:Female; D006801:Humans; D007454:Iodides / Q000276:immunology*; D007472:Iohexol / Q000031:analogs & derivatives; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012882:Skin Tests / Q000379:methods*; D014283:Triiodobenzoic Acids; D014581:Urticaria / Q000175:diagnosis / Q000276:immunology
D003287:Contrast Media; D007454:Iodides; D014283:Triiodobenzoic Acids; C057937:iomeprol; D007472:Iohexol; C038192:iopromide; C044834:iodixanol; D007479:Iopamidol; C054871:ioversol
Anaphylaxis; Contrast Media; Hypersensitivity; Skin Tests