Skin Test Reactivity Patterns in Patients Allergic to Iodinated Contrast Media: A Refined View.

Autor:	Ghiordanescu IM; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Institut Desbrest d'Épidémiologie et de Santé Publique, UMR UA11, University of Montpellier-INSERM, Montpellier, France; Dermatology and Allergy Clinic, Elias University Emergency Hospital, Bucharest, Romania. Electronic address: ileana-maria.ghiordanescu@drd.umfcd.ro., Molinari N; Institut Desbrest d'Épidémiologie et de Santé Publique, UMR UA11, University of Montpellier-INSERM, Montpellier, France; Division of Medical Information, La Colombiere University Hospital of Montpellier, Montpellier, France., Ciocănea-Teodorescu I; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Victor Babeș National Institute of Pathology, Bucharest, Romania., Schrijvers R; Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium., Motei C; Department of Pulmonology, Division of Allergy, Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France., Forsea AM; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Dermatology and Allergy Clinic, Elias University Emergency Hospital, Bucharest, Romania., Demoly P; Institut Desbrest d'Épidémiologie et de Santé Publique, UMR UA11, University of Montpellier-INSERM, Montpellier, France; Department of Pulmonology, Division of Allergy, Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France., Chiriac AM; Institut Desbrest d'Épidémiologie et de Santé Publique, UMR UA11, University of Montpellier-INSERM, Montpellier, France; Department of Pulmonology, Division of Allergy, Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France.
Jazyk:	angličtina
Zdroj:	The journal of allergy and clinical immunology. In practice [J Allergy Clin Immunol Pract] 2024 Mar; Vol. 12 (3), pp. 705-713.e6. Date of Electronic Publication: 2023 Oct 30.
DOI:	10.1016/j.jaip.2023.10.040
Abstrakt:	Background: Two-dimensional (2D) classifications of iodinated contrast media (ICM) are insufficient to explain the observed skin test (ST) reactivity patterns in patients with drug hypersensitivity reactions (DHRs) to ICM. Objective: To refine the current view on allergic DHRs to ICM by analyzing ST reactivity patterns in patients with previous reactions to ICM. Methods: Patients with a history of DHR to ICM and positive STs, who presented at the University Hospital of Montpellier between 2004 and 2022, were included in the study. The relative difference between every two ICM products was measured by Manhattan distance and odds ratios were computed for all pairs of products in the immediate reaction (IR) and non-immediate reaction (NIR) ST groups. Results: A total of 181 patients were included in the study. Odds ratio analysis identified significant associations between classical cross-reactive ICM, such as iohexol-ioversol, iohexol-iomeprol, iomeprol-ioversol, and iohexol-iodixanol in the IR ST group and iohexol-ioversol, iopromide-iohexol, and iomeprol-ioversol in the NIR ST group. We also identified uncommon associations, such as ioxitalamate-amidotrizoate in the IR ST group and amidotrizoate-iopamidol and amidotrizoate-ioxitalamate in the NIR ST group. The results were reflected by the Manhattan distance, which suggested the existence of clusters containing the same classically associated ICM as well as uncommon associations, which we hypothesize to be related to similarities in the 3D structure of the respective ICM. Conclusions: Current chemical (2D) classifications cannot explain all observed ST reactivity patterns. Whether the 3D structure can be integrated into the current classifications to interpret the observed ST reactivity patterns and predict tolerance to alternative ICM requires further research. (Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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