| Autor: |
Rosado Ingelmo A; Unidad de Alergia, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain., Doña Diaz I; Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Málaga, Spain., Cabañas Moreno R; Department of Allergy, Hospital La Paz, Health Research Institute (IdiPAZ), Madrid, Spain., Moya Quesada MC; Sección de Alergia CH Torrecárdenas, Almería, Spain., García-Avilés C; Unidad de Alergia, Hospital Moncloa, Madrid, Spain., García Nuñez I; Servicio de Alergología, Hospital Quirón Málaga, Málaga, Spain., Martínez Tadeo JI; Servicio de Alergología, Hospital Universitario Ntra Sra de Candelaria, Santa Cruz de Tenerife, Tenerife, Spain., Mielgo Ballesteros R; Servicio de Alergología, Hospital Universitario 12 de Octubre, Madrid, Spain., Ortega-Rodríguez N; Servicio de Alergia, Hospital Universitario de Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain., Padial Vilchez MA; Servicio de Alergologia, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain., Sánchez-Morillas L; Servicio de Alergologia, Hospital Clínico San Carlos, Madrid, Spain., Vila Albelda C; Unidad de Alergia, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain., Moreno Rodilla E; Servicio de Alergología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain., Torres Jaén MJ; Allergy Unit, IBIMA-Regional University Hospital of Málaga, UMA, Málaga, Spain. |
| Abstrakt: |
The objective of these guidelines is to ensure efficient and effective clinical practice. The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging. Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. |
