title: Non-ionic iodinated contrast media related immediate reactions: A mechanism study of 27 patients.
abstract: The underlying mechanism of non-ionic iodinated contrast media-related immediate reactions was evaluated in this study. Patients presenting at least grade II immediate reactions after non-ionic iodinated contrast media injection were enrolled. Basophil activation was evaluated by flow cytometry. The plasma concentration of human terminal complement complex SC5b-9, as well as concentrations of serum chymase, tryptase, human mast cell carboxypeptidase A3, human prostaglandin D2, and total IgE were measured by enzyme-linked immunosorbent assay. The basophil activation percentage was significantly higher in the study group than in the control group (17.94±21.06% vs 3.45±1.49%). The plasma concentration of human terminal complement complex SC5b-9 and concentrations of serum chymase, human mast cell carboxypeptidase A3, prostaglandin D2, tryptase, and total IgE were also significantly increased (236.99±318.21 vs 49.70±30.41ng/mL, 0.41±0.49 vs 0.09±0.06ng/mL, 1.17±0.67 vs 0.30±0.17ng/mL, 203.52±137.27 vs 102.28±48.72pg/mL, 3.81±0.22 vs 2.70±0.16ng/mL, 102.00±51.84 vs 19.97±2.75ng/mL, respectively). Both mast cells and basophils were activated in non-ionic iodinated contrast media to mediate immediate hypersensitivity, and mast cells may be involved. Different mechanisms, including IgE-dependent, complement-dependent, and direct membrane effects, contributed to mast cell and basophil activation. Individual patients may use a single or combined mechanism involving single or combined mast cells and basophils. Immediate reactions following non-ionic iodinated contrast media injection may be a mechanically heterogenous disease.
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China; Department of Pathology, Shanxi Provincial Hospital, Taiyuan 030012, China.
authors.forename: Liqin
authors.initials: L
authors.lastname: Zhai
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Xiangjie
authors.initials: X
authors.lastname: Guo
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Haoyue
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Jin
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zeng
authors.affiliation: Department of Computer Tomography, Shanxi Provincial Hospital, Taiyuan 030012, China.
authors.forename: Xiaoxian
authors.initials: X
authors.lastname: Tang
authors.affiliation: Department of Pathology, School of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China. Electronic address: caironggao@126.com.
authors.forename: Cairong
authors.initials: C
authors.lastname: Gao
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000009:adverse effects* / Q000737:chemistry; D004342:Drug Hypersensitivity / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D003287:Contrast Media
keywords: Basophil activation test; Immediate reaction; Mechanism; Non-ionic iodinated contrast media