Incidence and severity of acute allergic-like reactions to i.v. nonionic iodinated contrast material in children

Area of Science:

• Pediatric Radiology
• Contrast Media Reactions
• Allergy and Immunology

Background:

• Intravenous administration of iodinated contrast material is common in pediatric imaging.
• Understanding the incidence and severity of allergic-like reactions is crucial for patient safety.
• Low-osmolality nonionic contrast agents are generally considered safer than older ionic agents.

Purpose of the Study:

• To determine the frequency of acute allergic-like reactions in children receiving low-osmolality nonionic iodinated contrast material intravenously.
• To assess the severity spectrum of these reactions in the pediatric population.
• To identify potential risk factors associated with contrast material reactions in children.

Main Methods:

• Retrospective review of radiology contrast material reaction forms for pediatric patients (<19 years).
• Data collected from January 1999 to June 2006, encompassing 11,306 intravenous administrations.
• Evaluation of reaction type, severity, patient outcome, and medical history (previous reactions, premedication, asthma).

Main Results:

• 20 out of 11,306 (0.18%) pediatric administrations resulted in acute allergic-like reactions.
• The majority of reactions were mild (80%); however, moderate (5%) and severe (15%) reactions were also documented.
• No deaths were associated with contrast material administration. History of allergic reaction or asthma was noted in a subset of patients.

Conclusions:

• Acute allergic-like reactions to low-osmolality nonionic iodinated contrast material in children are infrequent.
• Similar to adults, most pediatric reactions are mild, but severe reactions necessitate vigilance.
• The study underscores the generally favorable safety profile of these contrast agents in pediatric populations.