Myths and misconceptions concerning contrast media-induced anaphylaxis: a narrative review

  title={Myths and misconceptions concerning contrast media-induced anaphylaxis: a narrative review},
  author={Ingrid B{\"o}hm and John N. Morelli and Knud Nairz and Patricia Silva Hasembank Keller and Johannes T. Heverhagen},
  journal={Postgraduate Medicine},
  pages={259 - 266}
ABSTRACT Contrast-enhanced radiological examinations are an increasingly important diagnostic tool in modern medicine. All approved and available contrast media (iodinated and gadolinium-based) are safe compounds that are well-tolerated by most patients. However, a small percentage of patients exhibit contrast medium-induced adverse drug reactions that are dose-dependent and predictable (type A) or an even smaller cohort experience so-called type B (dose-independent, non-predictable). To… 
Shelling the myth: allergies to Iodine containing substances and risk of reaction to Iodinated contrast media
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.
Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions
Although premedication reduces reoccurrence of mild iHR, it is not always efficacious and should be balanced against side effects, a high NNT and an uncertain efficacy physicians should not blindly rely on.
Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol
The preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions of non-ionic iodinated contrast media are reviewed systematically to reduce the risk of severe reactions.
Delayed hypersensitivity reaction after oral intake of non-ionic iodinated contrast medium
A case who acquired a delayed hypersensitivity reaction following the oral intake of a non-ionic iodinated CM is described.
The Use of Contrast Agents in Interventional Pain Procedures: A Multispecialty and Multisociety Practice Advisory on Nephrogenic Systemic Fibrosis, Gadolinium Deposition in the Brain, Encephalopathy After Unintentional Intrathecal Gadolinium Injection, and Hypersensitivity Reactions
The advisory provides recommendations on the selection of a specific gadolinium-based contrast agent in patients with renal insufficiency, those who had multiple gadolinia-enhanced magnetic resonance imaging examinations, and in cases of paraspinal injections.
Cross-Reactivity and Polyvalent Reactivity in Patients with Iodinated Contrast Medium Allergy: How to Use the Terms Correctly
The goal of this letter is to explain these terms, and thereby to enhance knowledge and clinical progress, by providing a detailed in-depth explanation of these terms.
Iodinated Contrast Media Allergy in Patients Hospitalized for Investigation of Chest Pain.


Iodinated Contrast Media and the Alleged "Iodine Allergy": An Inexact Diagnosis Leading to Inferior Radiologic Management and Adverse Drug Reactions.
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.
Delayed adverse reactions to iodinated contrast media and their risk factors.
Four risk factors for DARs were identified in the present investigation and skin reactions were observed significantly more frequently in patients for whom iotrolan was used, and 60% of these reactions were severe or moderate.
Late adverse reactions to intravascular iodine based contrast media: an update
The main risk factors for LAR are a previous reaction to contrast medium, a history of allergy, and interleukin-2 treatment, and most skin reactions are mild or moderate and self-limiting.
"Acute reactions to urographic contrast medium: incidence, clinical characteristics, and relationship to history of hypersensitivity states"--a commentary.
  • R. Katzberg
  • Medicine
    AJR. American journal of roentgenology
  • 2008
Increased use of contrast media on a daily basis has not decreased radiologists’ exposure to patient risk and possibly increases patient vulnerability to a greater extent today than during the ionic contrast media era because CT is a procedure that generally no longer involves direct physician–patient contact as was the case for urography.
Management of hypersensitivity reactions to iodinated contrast media
More research focusing on pathomechanisms, diagnostic testing and premedication is clearly needed in order to prevent CM‐induced hypersensitivity reactions in the future.
Allergy and contrast media
Clinical cases of severe reactions occurring after an intra-arterial injection of the same ionic ICM in three patients and two nonionic ICMs in two other patients are reported.
Radiocontrast media allergic reactions and interventional pain practice--a review.
Although the mechanisms of various RCM allergic-type reactions are not entirely understood, the interventional pain physician should have a basic understanding of patient risk factors, prevention, diagnosis, and treatment of these reactions.
[Anaphylactoid reactions and late skin reactions to iodinated contrast media: present state of the question--idea development].
Adverse reactions to iodinated contrast media (ICM) share various mechanisms and previous reactions to contrast media, cardiovascular disorders, beta-blockers, asthma, and atopy are risk factors.
Immediate reactions following iodinated contrast media injection: a study of 38 cases.