The Potential Utility of Iodinated Contrast Media (ICM) Skin Testing in Patients with ICM Hypersensitivity

다국어 초록 (Multilingual Abstract)

Both immediate and delayed hypersensitivity reactions to iodinated contrast media (ICM)are relatively common. However, there are few data to determine the clinical utility ofimmunologic evaluation of ICM. To evaluate the utility of ICM skin testing in patients withICM hypersensitivity, 23 patients (17 immediate and 6 delayed reactions) were enrolledfrom 3 university hospitals in Korea. With 6 commonly used ICM including iopromide,iohexol, ioversol, iomeprol, iopamidol and iodixanol, skin prick (SPT), intradermal (IDT) andpatch tests were performed. Of 10 patients with anaphylaxis, 3 (30.0%) and 6 (60.0%)were positive respectively on SPTs and IDTs with the culprit ICM. Three of 6 patients withurticaria showed positive IDTs. In total, 11 (64.7%) had positive on either SPT or IDT. Threeof 6 patients with delayed rashes had positive response to patch test and/or delayed IDT.
Among 5 patients (3 anaphylaxis, 1 urticaria and 1 delayed rash) taken subsequentradiological examinations, 3 patients administered safe alternatives according to the resultsof skin testing had no adverse reaction. However, anaphylaxis developed in the other 2patients administered the culprit ICM again. With 64.7% (11/17) and 50% (3/6) of thesensitivities of corresponding allergic skin tests with culprit ICM for immediate and delayedhypersensitivity reactions, the present study suggests that skin tests is useful for thediagnosis of ICM hypersensitivity and for selecting safe ICM and preventing a recurrence ofanaphylaxis caused by the same ICM.

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