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Related Experiment Videos

Delayed-type hypersensitivity to a nonionic, radiopaque contrast medium

S Courvoisier1, A J Bircher

  • 1Department of Dermatology, University Hospital, Basel, Switzerland.

Allergy
|February 4, 1999
PubMed
Summary
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Delayed hypersensitivity reactions to iodinated contrast media are rare. Patch testing is recommended for patients experiencing delayed exanthematous reactions to identify causative agents.

Area of Science:

  • Radiology
  • Allergy and Immunology

Background:

  • True allergic reactions to iodinated radiocontrast media are infrequent.
  • Delayed-type hypersensitivity reactions are seldom documented.

Observation:

  • A 61-year-old patient developed a maculopapular exanthema 7 days after percutaneous transluminal coronary angioplasty (PTCA) using iopamidol.
  • The patient later experienced a pruritic macular exanthema after a repeat PTCA with iopamidol, despite premedication.

Findings:

  • Patch tests confirmed hypersensitivity to iopamidol, iohexol, and ioversol, all nonionic contrast media.
  • The causative agent (iopamidol or trometamol additive) could not be definitively identified due to negative subsequent patch tests.

Implications:

  • Recommends patch or intradermal testing for delayed hypersensitivity reactions to contrast media.

Related Experiment Videos

  • Suggests immediate and delayed readings (days 2 and 3) for patch tests.
  • Highlights the importance of testing contrast media and their additives.