Open Access, Peer-reviewed
pISSN 2288-0402
eISSN 2288-0410
    Allergy Asthma Respir Dis. 2014 Nov;2(5):352-357. Korean.
    Published online Nov 28, 2014.
    https://doi.org/10.4168/aard.2014.2.5.352
    © 2014 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology
    Original Article

    Clinical features of delayed contrast media hypersensitivity

    Min-Hye Kim,1 Suh-Young Lee,2 Seung-Eun Lee,2 Mi-Yeong Kim,2 Eun-Jung Jo,2 Chang Min Park,3 Whal Lee,3 Sang Heon Cho,2 and 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, Email: helenmed@snu.ac.kr
    Received April 25, 2014; Revised June 16, 2014; Accepted June 17, 2014.

    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

    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.

    Tables

    Table 1
    Baseline characteristics of the study subjects (n=45)

    Table 2
    Clinical manifestations of delayed contrast media hypersensitivity (n=45)

    Table 3
    Clinical characteristics according to reactions in the follow-up contrast exposure

    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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    MeSH Terms
    Contrast Media*
    Electronic Health Records
    Female
    Humans
    Hypersensitivity*
    Hypersensitivity, Delayed
    Korea
    Premedication
    Recurrence
    Retrospective Studies
    Seoul
    Skin
    Metrics
    Share
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