jkma Journal of the Korean Medical Association J Korean Med Assoc 1975-8456 2093-5951 Korean Medical Association 10.5124/jkma.2020.63.3.155 jkma-63-155 Focused Issue of this Month Prescreening skin test effectiveness in predicting hypersensitivity to iodinated contrast media KimTae-Bum MD Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Corresponding author: Tae-Bum Kim E-mail: tbkim@amc.seoul.kr 32020 1732020 633 155158 28012020 4022020 Copyright © 2020 Korean Medical Association 2020 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

Hypersensitivity reaction to iodinated contrast media (ICM) is a persistent clinical issue owing to widespread use of computed tomography (CT) examinations. The question of whether routine performance of skin tests can predict hypersensitivity reactions to contrast media remains unresolved. Recently, a prospective study was performed to evaluate the role of an intradermal skin test as a prescreening test for hypersensitivity reactions to ICM. Fifteen (0.5%) of the 2,843 patients had positive skin test results prior to scheduled CT scans. However, none of the patients experienced a hypersensitivity reaction after administration of full-dose ICM. Meanwhile, 19 patients who experienced hypersensitivity reactions to an ICM challenge showed negative skin test results. The sensitivity and positive predictive value of skin tests for hypersensitivity reaction to ICM were both 0%. More studies should be conducted to confirm the uselessness of prescreening skin tests. In conclusion, a prescreening intradermal skin test prior to a CT scan has no significant clinical value as a tool for predicting hypersensitivity reactions to ICM. Therefore, prescreening skin tests should not be routinely performed.

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