Asia Pac Allergy.  2014 Apr;4(2):119-125. 10.5415/apallergy.2014.4.2.119.

Radiocontrast media hypersensitivity in the Asia Pacific region

• Lee SY
• Lim KW
• Chang YS

• KMID: 2397115
• DOI: http://doi.org/10.5415/apallergy.2014.4.2.119

Abstract

Radiocontrast media (RCM) is a major cause of drug hypersensitivity reactions as the medical application of RCM is increasing recently. RCM induced hypersensitivity reactions are considered as unpredictable type B reactions. Underlying mechanism of RCM induced hypersensitivity was previously regarded as nonimmunological mechanisms but recent studies suggest that immunological mechanisms could also be involved. As a result, the roles of skin tests and premedication are revisiting. As there has been no report that comprehensively summarized and analyzed the results of the studies on RCM hypersensitivity in the Asia Pacific region, we aimed to review the literatures on hypersensitivity reactions to RCM in terms of prevalence clinical manifestations, diagnostic approach, and preventive measures in the Asia Pacific region.

Keyword

Contrast media; Hypersensitivity; Asia Pacific

MeSH Terms

Asia*
Contrast Media*
Drug Hypersensitivity
Hypersensitivity*
Premedication
Prevalence
Skin Tests
Contrast Media

Reference

1. Yang MS, Lee SH, Kim TW, Kwon JW, Lee SM, Kim SH, Kwon HS, Park CH, Park HW, Kim SS, Cho SH, Min KU, Kim YY, Chang YS. Epidemiologic and clinical features of anaphylaxis in Korea. Ann Allergy Asthma Immunol. 2008; 100:31–36.

2. Kim MH, Park CH, Kim DI, Kim KM, Kim HK, Lim KH, Song WJ, Lee SM, Kim SH, Kwon HS, Park HW, Yoon CJ, Cho SH, Min KU, Kim YY, Chang YS. Surveillance of contrast-media-induced hypersensitivity reactions using signals from an electronic medical recording system. Ann Allergy Asthma Immunol. 2012; 108:167–171.

3. Song WJ, Chang YS. Recent applications of basophil activation tests in the diagnosis of drug hypersensitivity. Asia Pac Allergy. 2013; 3:266–280.

4. Kim SH, Jo EJ, Kim MY, Lee SE, Kim MH, Yang MS, Song WJ, Choi SI, Kim JH, Chang YS. Clinical value of radiocontrast media skin tests as a prescreening and diagnostic tool in hypersensitivity reactions. Ann Allergy Asthma Immunol. 2013; 110:258–262.

5. Brockow K, Romano A, Aberer W, Bircher AJ, Barbaud A, Bonadonna P, Faria E, Kanny G, Lerch M, Pichler WJ, Ring J, Rodrigues Cernadas J, Tomaz E, Demoly P, Christiansen C. European Network of Drug Allergy and the EAACI interest group on drug hypersensitivity. Skin testing in patients with hypersensitivity reactions to iodinated contrast media - a European multicenter study. Allergy. 2009; 64:234–241.

6. Bae YJ, Hwang YW, Yoon SY, Kim S, Lee T, Lee YS, Kwon HS, Cho YS, Shin MJ, Moon HB, Kim TB. The effectiveness of automatic recommending system for premedication in reducing recurrent radiocontrast media hypersensitivity reactions. PLoS One. 2013; 8:e66014.

7. Kim SS, Park CH, Park MJ, Choi SH, Kim YS, Park HW, Chang YS, Shin CS, Oh BH, Min KU, Kim YY, Cho SH. Adverse reactions to radio-contrast media in computed tomography (CT) in general population: incidence and clinical features. Korean J Asthma Allergy Clin Immunol. 2007; 27:157–161.

8. Munechika H, Hiramatsu Y, Kudo S, Sugimura K, Hamada C, Yamaguchi K, Katayama H. A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography. Eur Radiol. 2003; 13:185–194.

9. Thomas M, Peedicayil J, Koshi T, Korah I. Adverse reactions to radiocontrast media in an Indian population. Br J Radiol. 1999; 72:648–652.

10. Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1990; 175:621–628.

11. Katayama H, Kozuka T, Ebata K. Assessment of the side-effects of iomeprol. Eur J Radiol. 1994; 18:Suppl 1. S115–S119.

12. Pradubpongsa P, Dhana N, Jongjarearnprasert K, Janpanich S, Thongngarm T. Adverse reactions to iodinated contrast media: prevalence, risk factors and outcome-the results of a 3-year period. Asian Pac J Allergy Immunol. 2013; 31:299–306.

13. Ho J, Kingston RJ, Young N, Katelaris CH, Sindhusake D. Immediate hypersensitivity reactions to IV non-ionic iodinated contrast in computed tomography. Asia Pac Allergy. 2012; 2:242–247.

14. Jung JW, Kang HR, Kim MH, Lee W, Min KU, Han MH, Cho SH. Immediate hypersensitivity reaction to gadolinium-based MR contrast media. Radiology. 2012; 264:414–422.

15. Oi H, Yamazaki H, Matsushita M. Delayed vs. immediate adverse reactions to ionic and non-ionic low-osmolality contrast media. Radiat Med. 1997; 15:23–27.

16. Goksel O, Aydın O, Atasoy C, Akyar S, Demirel YS, Misirligil Z, Bavbek S. Hypersensitivity reactions to contrast media: prevalence, risk factors and the role of skin tests in diagnosis: a cross-sectional survey. Int Arch Allergy Immunol. 2011; 155:297–305.

17. Katayama H, Tanaka T. Clinical survey of adverse reactions to contrast media. Invest Radiol. 1988; 23:Suppl 1. S88–S89.

18. Yasuda R, Munechika H. Delayed adverse reactions to nonionic monomeric contrast-enhanced media. Invest Radiol. 1998; 33:1–5.

19. Akiyama M, Nakada T, Sueki H, Fujisawa R, Iijima M. Drug eruption caused by nonionic iodinated X-ray contrast media. Acad Radiol. 1998; 5:Suppl 1. S159–S161.

20. Hosoya T, Yamaguchi K, Akutsu T, Mitsuhashi Y, Kondo S, Sugai Y, Adachi M. Delayed adverse reactions to iodinated contrast media and their risk factors. Radiat Med. 2000; 18:39–45.

21. Munechika H, Hiramatsu Y, Kudo S, Sugimura K, Hamada C, Yamaguchi K, Katayama H. Delayed adverse reactions to nonionic contrast medium (iohexol) in IV use: multicentric study. Acad Radiol. 2002; 9:Suppl 1. S69–S71.

22. Yamaguchi K, Katayama H, Takashima T, Kozuka T, Seez P, Matsuura K. Prediction of severe adverse reactions to ionic and nonionic contrast media in Japan: evaluation of pretesting: a report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1991; 178:363–367.

23. Pinnobphun P, Buranapraditkun S, Kampitak T, Hirankarn N, Klaewsongkram J. The diagnostic value of basophil activation test in patients with an immediate hypersensitivity reaction to radiocontrast media. Ann Allergy Asthma Immunol. 2011; 106:387–393.

24. Worthley DL, Gillis D, Kette F, Smith W. Radiocontrast anaphylaxis with failure of premedication. Intern Med J. 2005; 35:58–60.

25. Kim SH, Lee SH, Lee SM, Kang HR, Park HW, Kim SS, Cho SH, Min KU, Kim YY, Chang YS. Outcomes of premedication for non-ionic radio-contrast media hypersensitivity reactions in Korea. Eur J Radiol. 2011; 80:363–367.

26. Shin MJ, Cho YJ. Management of adverse reaction to iodinated radiocontrast media. J Korean Med Assoc. 2012; 55:779–790.

27. Jacobsson BF, Jorulf H, Kalantar MS, Narasimham DL. Nonionic versus ionic contrast media in intravenous urography: clinical trial in 1,000 consecutive patients. Radiology. 1988; 167:601–605.

28. Yoshikawa H. Late adverse reactions to nonionic contrast media. Radiology. 1992; 183:737–740.