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

@article{Bhm2017MythsAM,
  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},
  year={2017},
  volume={129},
  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… 
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32 Citations

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.
Pretesting With the Injection of Small Doses of Contrast Media Is Dangerous and Should Be Omitted
  • I. Böhm
  • Medicine
    Vascular and endovascular surgery
  • 2018
TLDR
Intadermal testing up to undiluted contrast medium concentrations is the method of the choice both to verify the culprit contrast medium and to possibly find nonculprit contrast media that could be injected as safe alternate compounds.
Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions
TLDR
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.
Iodinated contrast media allergy is rare in patients undergoing sialography.
TLDR
Allergic reactions are exceedingly rare following sialo-CBCT studies regardless of a previous diagnosis of allergy, and pre-medication with corticosteroids and antihistamines is usually not warranted.
Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol
TLDR
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.
Lower dose and lower injection speed of iodinated contrast media: a new strategy to reduce the incidence rate of immediate hypersensitivity reactions.
  • I. Böhm
  • Medicine
    Quantitative imaging in medicine and surgery
  • 2020
TLDR
Lowering both the ICM-dose and the in ject ion speed is a reliable method to decrease the incidence of immediate hypersensitivity reactions, and should be used regularly in radiology routine settings.
Clinical impact of allergy and pre-medication in CT studies with low-osmolality intravenous iodinated contrast media.
Delayed hypersensitivity reaction after oral intake of non-ionic iodinated contrast medium.
TLDR
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
TLDR
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.
Risks of contrast media applied via the gastrointestinal route.
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