Debunking myths about “allergy” to radiocontrast media in an academic institution

@article{WestermannClark2015DebunkingMA,
  title={Debunking myths about “allergy” to radiocontrast media in an academic institution},
  author={Emma V Westermann-Clark and Amber N. Pepper and Neetu Talreja and Richard F. Lockey},
  journal={Postgraduate Medicine},
  year={2015},
  volume={127},
  pages={295 - 300}
}
Abstract Purpose: Patients with “allergy” to iodine and shellfish often do not obtain necessary radiologic procedures due to anxiety about potential radiocontrast media reactions. This study assesses the impact of an educational intervention to dispel these myths. Methods: The authors surveyed 252 internal medicine, emergency medicine, pediatrics, radiology, obstetrics/gynecology, and surgery health professionals before and after an educational intervention. Pre- and posttest responses were… 
Iodinated Contrast Media and the Alleged "Iodine Allergy": An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions.
TLDR
This data confirms the hypothesis that the diagnosis "iodine allergy" is potentially dangerous and results in uncertainty in clinical management and sometimes even ineffective prophylactic measures.
Knowledge and attitudes toward the safe use of intravascular contrast media in medical imaging among clinicians: A cross-sectional study
Background: Safe use of intravascular (IV) contrast media in medical imaging is important. We aimed to assess the clinicians’ knowledge and attitudes toward safe use of IV contrast media in medical
Allergy of iodine radiocontrast agent
Iodinated contrast media is widely used in radiology for instrumental examinations and procedures. It is used at least 100 million times per year worldwide [1,6,10]. First time iodine as contrast
Radiocontrast Media Hypersensitivity: Skin Testing Differentiates Allergy From Nonallergic Reactions and Identifies a Safe Alternative as Proven by Intravenous Provocation.
TLDR
Whether allergy diagnostics including skin and provocation testing can differentiate between nonallergic and allergic RCM hypersensitivity by identifying the causative RCM as well as tolerated alternative RCM is assessed.
Iodine allergy: Common misperceptions.
  • N. R. Wulf, J. Schmitz, A. Choi
  • Medicine
    American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
  • 2021
TLDR
It is indicated that iodine has not been shown to be the allergen responsible for allergic reactions to iodinated contrast media, amiodarone, povidone-iodine, and other iodine-containing compounds.
Knowledge gaps of drug allergy in children: a survey of primary care doctors
TLDR
The majority of primary care doctors reported a suspected drug allergy in children, the most common suspected drugs were antibiotics and skin symptoms were the main symptoms, and most doctors knew about the possibility to test for the drug allergy but only less than half of them referred patients for theDrug allergy workup.
Fidelity of Electronic Documentation for Reactions Prompting Premedication to Iodinated Contrast Media.
TLDR
Premedication prompts in the electronic health record are often erroneous because of inaccurate coding, incomplete data, and reaction misclassification, which result in inappropriate premedication for a substantial minority of patients.
Paranoia as an Antecedent and Consequence of Getting Ahead in Organizations: Time-Lagged Effects Between Paranoid Cognitions, Self-Monitoring, and Changes in Span of Control.
A six-month, time-lagged online survey among 441 employees in diverse industries was conducted to investigate the role paranoia plays as an antecedent and as a consequence of advancement in
An Exploratory Investigation of the Role of Openness in Relationship Quality among Emerging Adult Chinese Couples
TLDR
The result showed that female and male openness contribute differently to relationship quality; couples with similar high openness could experience better relationship quality than those with similar low openness traits; and when dyadic openness is dissimilar, it is better to be either relatively high or relatively low than to be moderate.
Shelling the myth: allergies to Iodine containing substances and risk of reaction to Iodinated contrast media
TLDR
There is a lack of understanding amongst local junior medical staff regarding administration of iodinated contrast media to patients with a history of allergy to iodinated substances, which may potentiate the unnecessary usage of pre-medication and ordering of non-contrast scans in the setting of a gold-standard enhanced scan.

References

SHOWING 1-10 OF 19 REFERENCES
Safe administration of contrast media: what do physicians know?
  • R. Confino‐Cohen, A. Goldberg
  • Medicine
    Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
  • 2004
TLDR
The level of knowledge about the adverse reactions of RCM among physicians is unsatisfactory, which may result in unwarranted use of expensive LOCAs or premedication in healthy patients, or failure to use these measures when indicated may endanger patients.
The relationship of radiocontrast, iodine, and seafood allergies: a medical myth exposed.
TLDR
Iodine is not an allergen, which confers an increased risk of reaction to contrast administration, but the risk of contrast administration is low, even in patients with a history of "iodine allergy," seafood allergy, or prior contrast reaction.
Clinical value of radiocontrast media skin tests as a prescreening and diagnostic tool in hypersensitivity reactions.
TLDR
RCM skin testing for screening is of no clinical utility in predicting hypersensitivity reactions and may have modest utility in retrospectively evaluating severe adverse reactions, according to a retrospective review of diagnostic skin test data.
Adverse reactions to intravascularly administered contrast media. A comprehensive study based on a prospective survey.
  • W. Shehadi
  • Medicine
    The American journal of roentgenology, radium therapy, and nuclear medicine
  • 1975
TLDR
The members of the Committee are of the firm belief that this program will become the foundation of a permanent national and international adverse reaction reporting system, thus meeting a great need.
Iodine allergy: an oyster without a pearl?
TLDR
It is shown that iodine does not confer a specific cross-reactivity between iodine-rich substances, that the cross- reactivity that does exist is nonspecific, and that the concept of iodine allergy is fallacious and may result in the inappropriate nonuse of IV contrast material in patients intolerant of antiseptics or seafood that contain iodine.
Skin test-positive immediate hypersensitivity reaction to iodinated contrast media: the role of controlled challenge testing.
TLDR
The use of controlled challenge tests based on skin test results are proposed to address the need in skin test-positive reactions in order to identify an alternative non-cross-reactive ICM.
Prevalence of acute reactions to iopromide: postmarketing surveillance study of 74,717 patients
TLDR
The safety of iopromide in routine clinical practice was shown to be comparable to the published safety profiles of other nonionic iodinated contrast agents.
The role of a documented allergic profile as a risk factor for radiographic contrast media reaction.
TLDR
The data suggest that allergic individuals are at twice the risk for developing adverse RCM reaction as compared with non-atopic subjects.
Repeat contrast medium reactions in premedicated patients: frequency and severity.
PURPOSE To determine the frequency, type, and severity of breakthrough and repeat breakthrough reactions to iodinated low-osmolality contrast medium (LOCM) in patients who were premedicated with
Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media.
TLDR
It is concluded that nonionic contrast media significantly reduce the frequency of severe and potentially life-threatening ADRs to contrast media at all levels of risk and that use of these media represents the most effective means of increasing the safety of contrast media examinations.
...
1
2
...