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Should patients with risk factors be tested for hypersensitivity to contrast media: a prospective study

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Abstract

Background

Previous hypersensitivity reactions to contrast media (CM), atopy, atopic disease, drug allergy, and age (20–29 or >55) are risk factors for CM hypersensitivity reactions. Our aim was to evaluate whether these risk factors should prompt skin testing for diagnosing CM allergy.

Methods

The study was conducted among patients referred for allergy testing with CM. Skin tests were performed with non ionic or gadolinium CM, recommended by a radiologist. After completion of tests patients were telephonically queried on their symptoms of reactions.

Results

151 risk patients (53 men, 98 women; mean age 55.2) were included in the study. Only 13 (9 %) had a history of hypersensitivity reaction to CM. Compared with the other patients, atopy was significantly more common in patients with a history of CM hypersensitivity reactions. Female gender and mean age were also higher, but not significant. All of the tests with CMs were negative. Only one patient reported urticaria within 1–2 min after administration of CM (telephonically).

Conclusions

Atopy can increase the risk of CM allergy. However, skin tests with CMs may be inefficient, unnecessary, and time-consuming, except in cases with a history of CM allergy. Premedication protocols appear to be beneficial in patients with a history of CM allergy and cannot be recommended for patients with well-controlled asthma, rhinitis, atopic dermatitis or history of drug allergy.

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Authors and Affiliations

  1. Department of Immunology and Allergy, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Başıbüyük mah. Maltepe, Istanbul, Turkey

    Fatma Merve Tepetam & İsmet Bulut

  2. Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey

    Nezihe Çiftaslan, Özlem Oruç, Dildar Duman & Meltem Ağca

  3. Department of Immunology and Allergy, İstanbul Medical Faculty, İstanbul University, İstanbul, Turkey

    Bahattin Çolakoğlu

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  1. Fatma Merve Tepetam
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  2. Nezihe Çiftaslan
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Correspondence to Fatma Merve Tepetam.

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The authors declare that they have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tepetam, F.M., Çiftaslan, N., Oruç, Ö. et al. Should patients with risk factors be tested for hypersensitivity to contrast media: a prospective study. Radiol med 121, 660–666 (2016). https://doi.org/10.1007/s11547-016-0646-1

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  • DOI: https://doi.org/10.1007/s11547-016-0646-1

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