J Korean Med Assoc.  2020 Mar;63(3):155-158. 10.5124/jkma.2020.63.3.155.

Prescreening skin test effectiveness in predicting hypersensitivity to iodinated contrast media

Affiliations
  • 1Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. tbkim@amc.seoul.kr

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.

Keyword

Computed tomography; Contrast media; Skin tests; Hypersensitivity; Predictive value of tests

MeSH Terms

Contrast Media*
Humans
Hypersensitivity*
Predictive Value of Tests
Prospective Studies
Skin Tests*
Skin*
Tomography, X-Ray Computed
Contrast Media
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