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An Aptamer-based Sensor for Unchelated GadoliniumIII
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Hypersensitivity to gadolinium-based contrast.

Rocío Sáenz de Santa María1,2, Marina Labella1,2, Gádor Bogas1,2

  • 1Allergy Unit, Hospital Regional Universitario de Málaga.

Current Opinion in Allergy and Clinical Immunology
|June 26, 2023
PubMed
Summary
This summary is machine-generated.

Gadolinium-based contrast agent hypersensitivity reactions (GBCA-HSRs) require thorough allergological evaluation. Skin tests and provocation tests are crucial for diagnosis and selecting safe alternatives, as cross-reactivity is high among similar agents.

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Area of Science:

  • Allergy and Immunology
  • Radiology
  • Pharmacology

Background:

  • Gadolinium-based contrast agents (GBCAs) are increasingly used in medical imaging.
  • While generally safe, infrequent hypersensitivity reactions (HSRs) can occur.
  • Suspected GBCA-HSRs necessitate careful evaluation to prevent future severe reactions.

Approach:

  • Review of scarce data on GBCA-HSRs, including skin tests and drug provocation tests (DPTs).
  • Analysis of the utility of premedication and cross-reactivity patterns among GBCAs.
  • Emphasis on allergological evaluation for patients with suspected GBCA-HSRs.

Key Points:

  • Premedication is often ineffective due to frequent breakthrough reactions.
  • Skin tests demonstrate high negative predictive value for guiding alternative GBCA selection.
  • DPTs remain essential for definitive diagnosis and identifying suitable alternatives.
  • High cross-reactivity exists among GBCAs within the same class, particularly macrocyclic agents.

Conclusions:

  • Thorough allergological assessment is critical for managing suspected GBCA-HSRs.
  • Skin testing and DPTs are vital tools for patient management and safety.
  • Understanding GBCA cross-reactivity is paramount for selecting appropriate alternative agents.