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Hypersensitivity to Gadolinium-Based Contrast Media.
M Teresa Gracia Bara1,2, Alicia Gallardo-Higueras1, Esther M Moreno1,2,3,4
1Allergy Service, University Hospital, Salamanca, Spain.
Frontiers in Allergy
|April 7, 2022
Summary
Hypersensitivity reactions to gadolinium-based contrast agents (GBCAs) used in MRI scans are increasing. Allergy evaluations suggest skin tests are accurate, but further research on cross-reactivity and drug provocation tests is needed.
Area of Science:
- Radiology and Imaging
- Allergy and Immunology
- Pharmacology
Background:
- Gadolinium-based contrast agents (GBCAs) enhance MRI sensitivity for diagnoses.
- An increasing number of hypersensitivity reactions to GBCAs have been reported.
- Understanding these reactions is crucial for patient safety in diagnostic imaging.
Approach:
- Systematic review of studies on immediate and delayed hypersensitivity reactions to GBCAs.
- Searched PubMed, SCOPUS, and EMBASE databases until September 2021.
- Included 26 articles with allergy evaluations, analyzing reaction characteristics and cross-reactivity.
Key Points:
- Analyzed 17 studies on immediate reactions, 6 on non-immediate, and 3 on both.
- Skin tests show acceptable accuracy for diagnosing GBCA hypersensitivity.
- Drug provocation tests are recommended when skin tests are negative or to identify alternative agents.
Conclusions:
- Cross-reactivity among macrocyclic GBCA agents appears to exist, but patterns require further investigation.
- Current data is limited by small patient numbers, necessitating larger studies.
- A management algorithm for GBCA hypersensitivity reactions is proposed.
Keywords:
allergygadolinium based contrast agenthypersensitivityimmediate reactionsnon-immediate reactionsskin testMore Related Videos
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