This document summarizes hypersensitivity reactions to iodinated contrast media. It discusses that while uncommon, reactions can occur immediately or in a delayed fashion. Immediate reactions are often mediated by histamine release and may involve IgE antibodies, while delayed reactions are typically T cell-mediated. Skin testing can help diagnose delayed reactions but its role in preventing repeat reactions requires more research. Premedication is controversial and not always effective in preventing reactions.

1. Hypersensitivity reaction to iodinated contrast media Thatchai Kampitak 20 May 2009

6. Gueant-Rodriguez RM et al. Curr Pharm Des 2006;12:3359-72

7. Idee JM et al. Fundam Clin Pharmacol 2005;19:263-81

8. Christensen C In Pichler WJ Drug hypersensitivity 2007

10. Brockow K et al. Allergy 2005;60:150-8

11. Immediate hypersensitivity reaction

14. Brockow K et al. Allergy 2005;60:150-8

18. Szebeni J. Curr Allergy Asthma Rep 2004;4:25-30

22. IgE-mediated mechanism Idee JM et al. Fundam Clin Pharmacol 2005;19:263-81

25. Skin test was positive in 50% of patients who were skin tested within 2-6 months Specificity of skin test was 96.3% 32 (26%) (4 by SPT, 30 by IDT) 122 Brockow K et al (Allergy 2009) BAT was positive in 3 patients 4 (4%) by IDT 96 Trcka J et al (Am J Roentgenol 2008) Median time to skin test was 3 and 48 months in positive and negative skin test patients (p <0.05) Respiratory allergy was more frequent in the positive skin test patient 9 (28%) (1 by SPT, 8 by IDT) 32 Kvedariene V et al (Clin Exp Allergy 2006) 9.3% cross-reactivity rate 19 (73%) by IDT 26 Laroche D et al (Contrast Mol Med Imaging 2006) Note Positive results Number of patients References

32. Idee JM et al. Fundam Clin Pharmacol 2005;19:263-81

33. Idee JM et al. Fundam Clin Pharmacol 2005;19:263-81

35. Delayed hypersensitivity reaction

37. Idee JM et al. Fundam Clin Pharmacol 2005;19:263-81

47. Thank You