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[Reactions to iodinated contrast media]
1Service de Pneumo-Allergologie, Hôpital Sainte-Marguerite, Marseille.
ICPs are used for many radiological examinations but are responsible for 4.6 to 8.5% of secondary reactions, which may perhaps be of the toxic or anaphylactoid types. Asthma, taking of beta-blockers, and previous reactions to an ICP injection are risk factors for an anaphylactoid reaction. Several mechanisms are involved but it seems to be exceptional that there is an IgE-dependent reaction. There is no paraclinical examination for diagnosis or prediction of reactions. There are hyperosmolar ICPs and others, more recent, which are non-ionic, of reduced osmolality. Non-ionic ICPs induce only a quarter of the secondary reactions of all types together and the reactions are often less severe. When a new injection, they reduce the risk of recurrence in patients who have already had reactions. The best subject protection lies in a premedication with corticosteroids and use of a non-ionic ICP. The latter should also be prescribed if possible, in all where increase in osmolality is contraindicated.
ICPs are used for many radiological examinations but are responsible for 4.6 to 8.5% of secondary reactions, which may perhaps be of the toxic or anaphylactoid types. Asthma, taking of beta-blockers, and previous reactions to an ICP injection are risk factors for an anaphylactoid reaction. Several mechanisms are involved but it seems to be exceptional that there is an IgE-dependent reaction. There is no paraclinical examination for diagnosis or prediction of reactions. There are hyperosmolar ICPs and others, more recent, which are non-ionic, of reduced osmolality. Non-ionic ICPs induce only a quarter of the secondary reactions of all types together and the reactions are often less severe. When a new injection, they reduce the risk of recurrence in patients who have already had reactions. The best subject protection lies in a premedication with corticosteroids and use of a non-ionic ICP. The latter should also be prescribed if possible, in all where increase in osmolality is contraindicated.