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Bo Bae Park1, Chang Han Park1
, In Young Nho1, Hae Sung Kim1, Nam Kyu Kang1, Suk Il Chang1, Jang Min Kim2
, In Young Nho1, Hae Sung Kim1, Nam Kyu Kang1, Suk Il Chang1, Jang Min Kim2
Abstract
Purpose
Hypersensitivity reactions to contrast media (CM) are one of the most common causes of drug adverse reactions. The overall prevalence of immediate hypersensitivity reaction (IHR) was 0.16%
–7.7% to nonionic CM. Although IHR to CM has been traditionally considered nonallergic, there is growing evidence that the mechanism of IHR to CM is mediated by IgE. It can be severe, even fatal, and a legal problem. To reduce IHR, the prescreening skin test is on the rise.
Methods
We reviewed cases of IHR to CM during enhanced computed tomography (CT) from 2008 to 2015 at a secondary hospital in South Korea. Patients who underwent enhanced CT were performed the 2-step prescreening skin test before nonionic CM-enhanced CT. If patients had adverse reactions to CM, the reactions were reported. IHR to CM was defined as an immediate reaction within 1 hour after CM administration. The Ring and Messmer system was used to classify the severity of reactions by grades I to IV, and we defined grades III and IV as severe reactions.
Figures and Tables
Fig. 1
Two-step prescreening skin testing. CM, contrast media; DM, diabetes mellitus; CT, computed tomography. *The first skin test was performed with a nonionic CM commonly used in our hospital. (mostly iohexol). **If a patient had a negative response to both 2 nonionic CM, one of them were selected randomly, If a patient had a negative response to only one nonionic CM, enhanced CT was performed by using the nonionic CM with negative reaction.
Table 1
Characteristics of the patients with immediate hypersensitivity reaction to noniondiated contrast media
Table 2
Clinical feature of immediate hypersensitivity reaction (n=60)
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