title: Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media.
abstract: The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM.
authors.affiliation: Università Vita-Salute San Raffaele, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Phone: 0039 02 2643 4078 Fax: 0039 02 2643 3786 E-mail: dellatorre.emanuel@hsr.it.
authors.forename: E
authors.initials: E
authors.lastname: Della-Torre
authors.affiliation: Università Vita-Salute San Raffaele, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Berti
authors.affiliation: Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Yacoub
authors.affiliation: Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Guglielmi
authors.affiliation: Università Vita-Salute San Raffaele, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Tombetti
authors.affiliation: Università Vita-Salute San Raffaele, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Sabbadini
authors.affiliation: Allergy Unit, IRCCS-San Martino-IST, University Hospital Genova, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Voltolini
authors.affiliation: Unit of Medicine and Clinical Immunology, IRCCS-San Raffaele Scientific Institute, Milan, Italy. Phone: 0039 02 2643 4078 Fax: 0039 02 2643 3786 E-mail: colombo.giselda@hsr.it.
authors.forename: G
authors.initials: G
authors.lastname: Colombo
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003287:Contrast Media / Q000009:adverse effects*; D019091:Critical Pathways; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D017613:Iodine Compounds / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D015203:Reproducibility of Results; D012307:Risk Factors; D012882:Skin Tests; D055815:Young Adult
chemical_list: D003287:Contrast Media; D017613:Iodine Compounds
keywords: Hypersensitivity; Iodinated contrast media; Premedication; Reactions; skin tests