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Measuring Local Anaphylaxis in Mice
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Iodinated Contrast Media and Anaphylaxis.

David M Lang1, Allison Ramsey2, Merin Kuruvilla3

  • 1Department of Allergy & Clinical Immunology, Cleveland Clinic, Cleveland, OH, USA.

Immunology and Allergy Clinics of North America
|April 3, 2026
PubMed
Summary
This summary is machine-generated.

Immediate hypersensitivity reactions (IHRs) to iodinated contrast media are typically non-IgE mediated. Premedication for IHRs is controversial due to lower rates with low osmolar agents, but other strategies exist.

Keywords:
Anaphylaxis (contrast media)High osmolar contrast mediaIodinated contrast mediaLow osmolar contrast mediaPretreatment (contrast media)Skin testing (contrast media)

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Area of Science:

  • Radiology
  • Allergy and Immunology

Background:

  • Immediate hypersensitivity reactions (IHRs) to iodinated contrast media (ICM) are a concern in diagnostic imaging.
  • These reactions are often non-immunoglobulin E (IgE)-mediated, involving mast cell and basophil degranulation.
  • IgE-mediated reactions, though less common, also occur.

Purpose of the Study:

  • To evaluate the current understanding and management of immediate hypersensitivity reactions to iodinated contrast media.
  • To discuss the evolving role of premedication in light of newer contrast agents.
  • To outline alternative risk-reduction strategies for patients with a history of contrast reactions.

Main Methods:

  • Review of existing literature on hypersensitivity reactions to iodinated contrast media.
  • Analysis of the impact of low osmolar contrast media on reaction rates.
  • Discussion of diagnostic and therapeutic interventions for contrast hypersensitivity.

Main Results:

  • Low osmolar contrast media are associated with a substantially lower rate of IHRs compared to high osmolar agents.
  • The routine use of premedication for prior reactors is now considered controversial.
  • Alternative strategies like switching agents, skin testing, provocation testing, and desensitization are viable options.

Conclusions:

  • The decision to premedicate for IHRs to iodinated contrast media requires careful consideration of risks and benefits.
  • Alternative risk-reduction strategies should be considered for selected patients.
  • Further research may clarify optimal management protocols for contrast hypersensitivity.