Laroche D, Namour F, Lefrançois C, Aimone-Gastin I, Romano A, Sainte-Laudy J, Laxenaire M C, Guéant J L
Laboratoire de Pathologie Cellulaire et Moléculaire en Nutrition, EP CNRS 616 et Département d'Anesthésie, Université de Nancy, France.
Allergy. 1999;54 Suppl 58:13-6.
Some adverse reactions to iodinated contrast material (ICM) are considered allergy-like, with cutaneous, cardiovascular, respiratory, and digestive symptoms. Allergy-like reactions are usually unpredictable. Reactions are more frequent with ionic than with nonionic material, but the frequency of deaths is almost identical. In a recent study, 20 severe unexpected reactions to ICM, including 10 life-threatening reactions and one death, were investigated by measuring mediators in blood, within the first minutes or hours of reaction. The responsible ICMs were mostly ionic materials. Histamine and tryptase release correlated with the severity of the reaction. Specific IgE against the responsible ICM was significantly higher in reactors than in controls. A few patients had positive skin tests to the administered ICM, suggesting type-I allergic reaction. Only 2.4% and 3.1% of the cases yielded a positive IgE-RIA, in a second retrospective study which included 165 patients recruited during a 4-year period. In conclusion, IgE-mediated anaphylaxis is rare, but it may be one of the possible mechanisms of severe adverse reactions to ICM.
一些对碘化造影剂（ICM）的不良反应被认为类似过敏反应，伴有皮肤、心血管、呼吸和消化系统症状。类似过敏反应通常不可预测。离子型造影剂引发的反应比非离子型造影剂更频繁，但死亡频率几乎相同。在最近一项研究中，通过在反应的最初几分钟或几小时内测量血液中的介质，对20例ICM严重意外反应进行了调查，其中包括10例危及生命的反应和1例死亡。引发反应的ICM大多为离子型材料。组胺和类胰蛋白酶释放与反应的严重程度相关。发生反应者体内针对引发反应的ICM的特异性IgE显著高于对照组。少数患者对所使用的ICM皮肤试验呈阳性，提示为I型过敏反应。在另一项回顾性研究中，在4年期间招募了165例患者，仅有2.4%和3.1%的病例IgE-RIA呈阳性。总之，IgE介导的过敏反应很少见，但可能是ICM严重不良反应的潜在机制之一。
