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radiological contrast in iodine allergy

Ingrid Boehm, Knud Nairz, John Morelli, Patricia Silva Hasembank Keller, Johannes Thomas Heverhagen
Contrast-enhanced radiological examinations are important diagnostic tools in modern medicine. Currently, all approved and available iodinated and gadolinium-based contrast agents are safe and well-tolerated by most patients. However, approximately 2% of patients receiving iodinated contrast media exhibit hypersensitivity reactions. Patients with a history of such a reaction are at increased risk upon reexposure. Therefore, they are subjected to a prophylaxis such as injection of antiallergy drugs or general anaesthesia...
November 2017: British Journal of Radiology
Qin-Lan Chen, Xiao-Ying Zhao, Xiao-Mi Wang, Na Lv, Ling-Ling Zhu, Hui-Min Xu, Quan Zhou
The authors retrospectively analyzed the pattern and characteristics of non-laboratory-based adverse drug reactions (ADRs) induced by intravenous radiocontrast agents in a large-scale hospital in China during 2014-2015. There were 314 ADR cases among 118,208 patients receiving enhanced CT or MRI examinations. The frequency of moderate/severe ADRs defined by Chinese Society of Radiology (ie, severe vomiting, systematic urticaria, facial swelling, dyspnea, vasovagal reaction, laryngeal edema, seizure, trembling, convulsions, unconsciousness, shock, death, and other unexpected adverse reactions) was rare (0...
2017: Therapeutics and Clinical Risk Management
Ingrid Böhm, Knud Nairz, John N Morelli, Patricia Silva Hasembank Keller, Johannes T Heverhagen
Purpose To test the hypothesis that the incomplete diagnosis "iodine allergy" is a possibly dangerous concept for patients under routine radiologic conditions. Materials and Methods 300 patients with a history of an "iodine allergy" were retrospectively screened and compared with two age-, sex-, and procedure-matched groups of patients either diagnosed with a nonspecific "iodine contrast medium (ICM) allergy" or an allergy to a specific ICM agent. For all groups, the clinical symptoms of the most recent past adverse drug reaction (ADR), prophylactic actions taken for subsequent imaging, and ultimate outcome were recorded and analyzed...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
So Yeon Kim, Seong Ho Park, En-Haw Wu, Z Jane Wang, Thomas A Hope, Wei-Chou Chang, Benjamin M Yeh
OBJECTIVE: The purpose of this article is to identify risk factors for arterial phase respiratory motion artifact in gadoxetate disodium-enhanced liver MRI. MATERIALS AND METHODS: We retrospectively identified 220 consecutive patients who underwent 357 MRI examinations, including 68 patients who underwent multiple MRI examinations, with gadoxetate disodium between 2010 and 2013. The arterial phase timing was determined by a fluoroscopic-triggering method. T1-weighted unenhanced and contrast-enhanced images were reviewed to record respiratory motion artifact, which was graded on a 5-point scale...
June 2015: AJR. American Journal of Roentgenology
Emma Westermann-Clark, Amber N Pepper, Neetu Talreja, Richard F Lockey
PURPOSE: Patients with "allergy" to iodine and shellfish often do not obtain necessary radiologic procedures due to anxiety about potential radiocontrast media reactions. This study assesses the impact of an educational intervention to dispel these myths. METHODS: The authors surveyed 252 internal medicine, emergency medicine, pediatrics, radiology, obstetrics/gynecology, and surgery health professionals before and after an educational intervention. Pre- and posttest responses were analyzed to assess the impact of the intervention on beliefs about radiocontrast media reactions and their perceived relationship to shellfish allergy and iodine "allergy...
April 2015: Postgraduate Medicine
Michael J Callahan, Sabah Servaes, Edward Y Lee, Alexander J Towbin, Sjirk J Westra, Donald P Frush
OBJECTIVE: There are limited data available on the use of i.v. contrast media for CT studies in the pediatric population. The purpose of this study is to determine the practice patterns of i.v. contrast media usage for pediatric CT by members of the Society for Pediatric Radiology (SPR). MATERIALS AND METHODS: SPR members were surveyed regarding the use of i.v. contrast media for pediatric CT studies. Questions pertained to information required before administering i...
April 2014: AJR. American Journal of Roentgenology
Eduardo Martín Arranz, Rafael Rey Sanz, María Dolores Martín Arranz, Francisco Gea Rodríguez, Pedro Mora Sanz
INTRODUCTION: Radiologic contrasts are required during endoscopic retrograde cholangiopancreatography (ERCP). The most frequently used are iodine-based contrast media. Controversy still surrounds the optimal strategy in patients with previous adverse reactions to iodine contrasts that need to undergo an ERCP. OBJECTIVE: To evaluate the safety and efficacy of a gadolinium-derived contrast medium in patients with previous reactions to iodine-derived agents during ERCP...
December 2011: Gastroenterología y Hepatología
Marie-France Bellin, Fulvio Stacul, Judith A W Webb, Henrik S Thomsen, Sameh K Morcos, Torsten Almén, Peter Aspelin, Olivier Clement, Gertraud Heinz-Peer, Peter Reimer, Aart van der Molen
DEFINITION: Late adverse reactions (LAR) to contrast media (CM) are defined as reactions occurring 1 h to 1 week after exposure. NEED FOR REVIEW: In view of more prospective studies of LAR and new data about their pathophysiology, the Contrast Medium Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) reviewed the literature on LAR and updated their guidelines. CLINICAL FEATURES AND PATHOLOGY: LAR after CM include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever...
November 2011: European Radiology
Ryan B O'Malley, Richard H Cohan, James H Ellis, Elaine M Caoili, Matthew S Davenport, Jonathan R Dillman, Shokoufeh Khalatbari, James D Myles
PURPOSE: The aim of this study was to assess Society of Uroradiology member use of premedication before the intravenous administration of low-osmolality iodinated contrast materials (LOCM) and gadolinium-based contrast materials (GBCM). METHODS: Society of Uroradiology members were invited to complete a Web-based survey concerning the use of premedication. The survey included scenarios concerning intravenous LOCM or GBCM injection in which respondents were asked whether they would recommend premedication or withhold contrast material injection...
May 2011: Journal of the American College of Radiology: JACR
Ingrid Böhm, Heiko Alfke, Klaus Jochen Klose
BACKGROUND: Hypersensitivity (allergic or non-allergic) reactions that occur after contrast medium (CM) injection are usually related to the CM. Recent studies, and case reports lack the analysis of alternate causes that could be also responsible in individual cases. PATIENTS AND METHODS: We investigated the individual relevant factor/causative agent of adult patients with hypersensitivity reactions that occurred in radiological units during CM-enhanced procedures (CT, angiography, urography, or MR-examinations)...
November 2011: European Journal of Radiology
Saurabh Jha, Alex Ho, Mythreyi Bhargavan, Jean B Owen, Jonathan H Sunshine
OBJECTIVE: The utility of various imaging techniques and strategies for the diagnosis of pulmonary embolism has been studied in randomized control trials and extensively described in the literature. CT and ventilation-perfusion scintigraphy are the mainstays of diagnosis, and MRI is emerging. The purpose of this study was to assess the diagnostic approach to pulmonary embolism practiced by emergency physicians and advised by radiologists. MATERIALS AND METHODS: Questionnaires were sent to emergency physicians and radiologists in Pennsylvania...
January 2010: AJR. American Journal of Roentgenology
Christopher H Hunt, Robert P Hartman, Gina K Hesley
OBJECTIVE: The purpose of this study was to determine the frequency and characteristics of adverse effects of low-osmolar iodinated and gadolinium contrast agents in a single-center experience with a large number of cases. MATERIALS AND METHODS: A retrospective review of all intravascular doses of low-osmolar iodinated and gadolinium contrast materials administered from 2002 through 2006 was conducted. Adverse effects were identified through the use of radiologist and nurse event recording...
October 2009: AJR. American Journal of Roentgenology
A F Kopp, K J Mortele, Y D Cho, P Palkowitsch, M A Bettmann, C D Claussen
BACKGROUND: Iodinated X-ray contrast media (CM) are recognized worldwide to be among the safest and most widely used injectable drugs. However, adverse drug reactions (ADRs) may still occur, ranging in severity from minor disturbances to severe and potentially fatal complications. PURPOSE: To prospectively determine the incidence and characteristics of acute ADRs during clinical utilization of a single nonionic monomeric contrast agent, iopromide, in routine radiological practice in a large number of nonselected patients...
October 2008: Acta Radiologica
R van Dijk Azn, J F M Wetzels, M A G J ten Dam, N J M Aarts, M L H H Schimmelpenninck-Scheiffers, M P Freericks, S A M Said, R W F Geenen, A Stuurman, J J E van Everdingen
Annually, 0.5-1 million injections of contrast media containing iodine are administered in the Netherlands. Almost all contrast media nowadays are low-osmolar and nonionic. Nevertheless, the development ofcontrast-induced nephropathy is still a relevant clinical problem. Through an initiative by the Radiological Society of the Netherlands and with aid of the Dutch Institute for Healthcare Improvement (CBO), a guideline was conceived for the intravascular use of iodine-containing contrast media, based on recent scientific literature...
March 29, 2008: Nederlands Tijdschrift Voor Geneeskunde
Jiri Trcka, Claudia Schmidt, Cornelia S Seitz, Eva-B Bröcker, Gerd E Gross, Axel Trautmann
OBJECTIVE: Contrast material is generally well tolerated although approximately 1% of patients who receive low-osmolar nonionic contrast material will develop anaphylaxis symptoms. Because most anaphylactic reactions are mild and nonallergic, clinically mimicking immunoglobulin E (IgE)-mediated allergy, diagnostic skin testing has been discussed controversially in the past and prophylactic pretreatment drug regimens are recommended instead. In the past 6 years, all patients with contrast material-induced anaphylaxis have been subjected to allergologic diagnostic procedures to clearly differentiate allergic and nonallergic anaphylaxis...
March 2008: AJR. American Journal of Roentgenology
Dorette Noorhasan, Michael J Heard
OBJECTIVE: To report the successful use of gadolinium radiologic contrast for hysterosalpingography. DESIGN: Case report. SETTING: Outpatient care in a private practice setting. PATIENT(S): One female patient entering and finishing study. INTERVENTION(S): Hysterosalpingogram. MAIN OUTCOME MEASURE(S): Interpretability of radiological imaging. RESULT(S): Visualization of a normal uterine cavity and fallopian tubes with bilateral patency was confirmed during the procedure...
December 2005: Fertility and Sterility
R F J Browne, C Zwirewich, W C Torreggiani
The diagnosis of urinary tract infection (UTI) in the adult is primarily based on typical patient symptomatology and urinary evaluation for the presence of bacteria and white blood cells. Uncomplicated UTI usually does not require radiological evaluation unless it is recurrent. Imaging should, in general, be reserved for those patients in whom conventional treatment has failed or those who have recurrent or unusually severe symptoms. Patients with conditions predisposing to infection, or complications thereof, such as diabetes mellitus or immunocompromised states, may also benefit from early imaging...
March 2004: European Radiology
Judith A W Webb, Fulvio Stacul, Henrik S Thomsen, Sameh K Morcos
Late adverse reactions to intravascular iodinated contrast media are defined as reactions occurring 1 h to 1 week after contrast medium injection. They have received increasing interest over the past decade, but their prevalence remains uncertain and their pathophysiology is not fully understood. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and to issue guidelines. An extensive literature search was carried out and summarized in a report...
January 2003: European Radiology
F Bartolucci, M Cecarini, G Gabrielli, R Abbiati, M Barberio, P Busilacchi
PURPOSE: This prospective, non-randomized study was aimed at evaluating the incidence of Delayed Adverse Drug Reactions (DADRs) to iodinated contrast agents and to evaluate possible risk factors to the development of these reactions. DADRs are those reactions occurring one to 48 hours after contrast medium administration. Their symptoms and frequency are not well defined, but the majority of DADRs are mild in intensity and resolve spontaneously without sequelae. In the literature, DADRs are reported to occur in 1 to 15% of patients undergoing contrast-enhanced examinations...
October 2000: La Radiologia Medica
V Pelagatti, H Bagheri, P Fernandez, N Railhac, C Bregeon, J J Railhac, J L Montastruc
The use of iodinated contrast agents is associated with adverse drug reactions (ADRs) (mainly allergic). Data from the literature suggest a frequency of ADRs ranging from 5 to 8 per cent for the whole group of iodinated contrast agents. The present systematic prospective study performed over a period of six months investigated ADRs in a Radiology Department of the University Hospital in Toulouse. After 1480 injections of iodinated contrast agents, only five ADRs (i.e. 0.34 per cent) were observed. However, the frequency remained higher in patients with a history of allergy (1...
May 2000: Thérapie
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