title: Myths and misconceptions concerning contrast media-induced anaphylaxis: a narrative review.
abstract: Contrast-enhanced radiological examinations are an increasingly important diagnostic tool in modern medicine. All approved and available contrast media (iodinated and gadolinium-based) are safe compounds that are well-tolerated by most patients. However, a small percentage of patients exhibit contrast medium-induced adverse drug reactions that are dose-dependent and predictable (type A) or an even smaller cohort experience so-called type B (dose-independent, non-predictable). To increase patients' safety, recommendations/guidelines have been put forth in the literature and advice passed down informally by radiologists in practice to ensure contrast media safety. Through these, both reasonable suggestions as well as misinterpretations and myths (such as the misleading terms "allergy-like" reactions, and "iodine-allergy", the wrong assumption that the initial contact to a contrast medium could not induce an allergy, the estimation that an anti-allergy premedication could suppress all possible adverse reactions, and interleukin-2 as a risk/trigger for contrast medium adverse events) have arisen. Since the latter are not only unhelpful but also potentially reduce patients' safety, such myths and misconceptions are the focus of this review.
authors.affiliation: a Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital , University of Bern , Bern , Switzerland.|b Radiology Laboratory, Department Clinical Research , University of Bern , Bern , Switzerland.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Böhm
authors.affiliation: c Department of Radiology , St. John's Medical Center , Tulsa , OK , USA.
authors.forename: John
authors.initials: J
authors.lastname: Morelli
authors.affiliation: a Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital , University of Bern , Bern , Switzerland.
authors.forename: Knud
authors.initials: K
authors.lastname: Nairz
authors.affiliation: a Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital , University of Bern , Bern , Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Silva Hasembank Keller
authors.affiliation: a Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital , University of Bern , Bern , Switzerland.|b Radiology Laboratory, Department Clinical Research , University of Bern , Bern , Switzerland.
authors.forename: Johannes T
authors.initials: JT
authors.lastname: Heverhagen
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced* / Q000503:physiopathology*; D003287:Contrast Media / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000503:physiopathology; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D007159:Immunologic Tests; D007376:Interleukin-2 / Q000494:pharmacology / Q000627:therapeutic use; D007455:Iodine / Q000009:adverse effects; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D006633:Histamine Antagonists; D007376:Interleukin-2; D007455:Iodine
keywords: Contrast media; allergy; allergy-like; drug hypersensitivity; drug safety; premedication; recombinant interleukin 2 protein