Clinical features of delayed contrast media hypersensitivity

Min-Hye Kim; Suh-Young Lee; Seung-Eun Lee; Mi-Yeong Kim; Eun-Jung Jo; Chang Min Park; Whal Lee; Sang Heon Cho; Hye-Ryun Kang

doi:10.4168/aard.2014.2.5.352

Journal List > Allergy Asthma Respir Dis > v.2(5) > 1059056

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Kim, Lee, Lee, Kim, Jo, Park, Lee, Cho, and Kang: Clinical features of delayed contrast media hypersensitivity

Original Article

Allergy, Asthma & Respiratory Disease 2014; 2(5): 352-357.

Published online: 28 November 2014

DOI: https://doi.org/10.4168/aard.2014.2.5.352

Clinical features of delayed contrast media hypersensitivity

Min-Hye Kim¹, Suh-Young Lee², Seung-Eun Lee², Mi-Yeong Kim², Eun-Jung Jo², Chang Min Park³, Whal Lee³, Sang Heon Cho², Hye-Ryun Kang²

¹Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

²Department of Internal Medicine, Institute of Allergy and Clinical Immunology, Seoul National University College of Medicine, Seoul, Korea.

³Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea.

Correspondence to: Hye-Ryun Kang. Department of Internal Medicine, Institute of Allergy and Clinical Immunology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-0820, Fax: +82-2-762-9662, helenmed@snu.ac.kr

Received 25 April 2014 Revised 16 June 2014 Accepted 17 June 2014

(open-access):

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/).

Abstract

Purpose

Delayed hypersensitivity reaction can occur in a couple of hours to several days after injection of iodine-based contrast media (ICM). ICM-related delayed type hypersensitivity is not common but increasing as rapid growth of ICM use. Nevertheless, objective data on delayed type hypersensitivity are still scarce worldwide including Korea. This study was performed to investigate the clinical features of ICM-induced delayed hypersensitivity in Korean patients.

Methods

We retrospectively reviewed the electronic medical records of patients diagnosed with delayed hypersensitivity to ICM from January 2009 to December 2012 at Seoul National University Hospital and analyzed the data to identify the clinical characteristics of these patients.

Results

A total of 44 cases were diagnosed as delayed-type hypersensitivity to ICM. The mean age was 54 years, and 70.5% were female. The mean number of previous ICM exposure was 3.8, and skin reactions were the most common symptoms. In 45% of patients, hypersensitivity reaction developed on the first exposure to ICM. Among the 27 patients exposed to ICM again, hypersensitivity reactions recurred in only 4 patients (14.8%). There was no difference of recurrence rate according to the use of premedication or the change in ICM.

Conclusion

In this study, we observed a female predominance and a low recurrence rate in delayed hypersensitivity to ICM. Premedication and ICM change was not effective in preventing recurrence of delayed type reactions.

Keywords: Contrast media, Delayed hypersensitivity, Recurrence

Figures and Tables

Fig. 1

Number of patients according to their symptoms onset time.

Fig. 2

Number of previous contrast exposure among patients with delayed contrast media hypersensitivity.

Fig. 3

Management and follow-up results after delayed contrast media hypersensitivity. RCM, radiocontrast media.

Table 1

Baseline characteristics of the study subjects (n=45)

Values are presented as mean±standard deviation or number (%).

RCM, radiocontrast media; HTN, hypertension.

Table 2

Clinical manifestations of delayed contrast media hypersensitivity (n=45)

Values are presented as number (%).

Table 3

Clinical characteristics according to reactions in the follow-up contrast exposure

Values are presented as mean±standard deviation or number (%).

RCM, radiocontrast media.

Notes

This research was supported by a grant from Ministry of Food and Drug Safety to operation of the Regional Pharmacovigilance Center in 2014.

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