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Published on: April 18, 2013
Should patients with risk factors be tested for hypersensitivity to contrast media: a prospective study
Fatma Merve Tepetam1, Nezihe Çiftaslan2, Özlem Oruç2
1Department of Immunology and Allergy, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Başıbüyük mah. Maltepe, Istanbul, Turkey. fatmamervealan@hotmail.com.
Background:
Previous hypersensitivity reactions to contrast media (CM), atopy, atopic disease, drug allergy, and age (20-29 or >55) are risk factors for CM hypersensitivity reactions. Our aim was to evaluate whether these risk factors should prompt skin testing for diagnosing CM allergy.
Methods:
The study was conducted among patients referred for allergy testing with CM. Skin tests were performed with non ionic or gadolinium CM, recommended by a radiologist. After completion of tests patients were telephonically queried on their symptoms of reactions.
Results:
151 risk patients (53 men, 98 women; mean age 55.2) were included in the study. Only 13 (9 %) had a history of hypersensitivity reaction to CM. Compared with the other patients, atopy was significantly more common in patients with a history of CM hypersensitivity reactions. Female gender and mean age were also higher, but not significant. All of the tests with CMs were negative. Only one patient reported urticaria within 1-2 min after administration of CM (telephonically).
Conclusions:
Atopy can increase the risk of CM allergy. However, skin tests with CMs may be inefficient, unnecessary, and time-consuming, except in cases with a history of CM allergy. Premedication protocols appear to be beneficial in patients with a history of CM allergy and cannot be recommended for patients with well-controlled asthma, rhinitis, atopic dermatitis or history of drug allergy.
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