Intradermal testing with radiocontrast media to prevent recurrent adverse reactions

Sung Ryeol Kim, Kyung Hee Park, Yoo Jin Hong, Young Taik Oh, Jung Won Park, Jae Hyun Lee

Research output: Contribution to journalArticle

Abstract

Objective. Adverse drug reactions (ADRs) to radiocontrast media are a significant social and economic burden and are difficult to predict. Because some ADRs to radiocontrast media may be immunologically induced, a skin test with diluted 1:10 radiocontrast media has been used to predict ADRs. However, using this test in clinical practice is difficult because of its low sensitivity. Subjects and Methods. This study enrolled 36 patients with a history of immediate ADR to radiocontrast media who visited the Allergy and Asthma Clinic of Severance Hospital from 2017 to 2018. Patients underwent intradermal testing (IDT) with five types of diluted (1:10) and undiluted radiocontrast media (iohexol, iobitridol, iopamidol, iopromide, and iodixanol). The IDT result was regarded as positive if at least one radiocontrast medium elicited a positive reaction. Positivity of IDT and sensitivity to the culprit radiocontrast medium were calculated and compared. For subsequent CT examinations with a radiocontrast medium, the contrast agent eliciting a negative skin reaction in IDT was selected, excluding the previous culprit radiocontrast medium. Results. IDT positivity and sensitivity for the culprit radiocontrast medium at 1:10 dilution were 47.2% and 47.2%, respectively, whereas the positivity and sensitivity for the undiluted radiocontrast medium were 86.1% and 75.0%, respectively. The positivity and sensitivity were higher with frequent radiocontrast medium use or with severe reaction. Of 22 patients who underwent another CT examination with the contrast medium selected on the basis of IDT results, 21 (95.5%) did not experience an ADR. Conclusion. IDT to prevent ADR should be performed with undiluted radiocontrast medium. Selecting an alternative radiocontrast agent on the basis of IDT results can be clinically useful to prevent recurrent ADRs to radiocontrast media.

Original languageEnglish
Pages (from-to)1187-1193
Number of pages7
JournalAmerican Journal of Roentgenology
Volume213
Issue number6
DOIs
Publication statusPublished - 2019 Jan 1

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Intradermal testing with radiocontrast media to prevent recurrent adverse reactions'. Together they form a unique fingerprint.

  • Cite this