Department of Pulmonary Diseases, Division of Allergy and Clinical Immunology, Ankara University, Ankara, Turkey.
Int Arch Allergy Immunol. 2011;155(3):297-305. doi: 10.1159/000320760. Epub 2011 Feb 3.
Hypersensitivity to contrast media (CMs) may be common and serious.
To evaluate the prevalence of CM hypersensitivity, risk factors associated with it and the role of skin testing in its diagnosis.
A structured questionnaire was administered to patients who underwent computed tomography during a 1-year period. Skin tests with CMs, including skin prick tests (SPTs), intradermal tests (IDTs) and patch tests (PTs), were conducted on CM reactors (n = 24). Volunteers who tolerated CM exposure or had never been exposed to any CMs served as controls (n = 37).
A total of 1,131 patients (630 females and 501 males; mean age 55 ± 14.2 years) were enrolled in the study. The prevalence of historical and current CM reactors was 33/1,131 (2.92%) and 8/1,105 (0.72%), respectively. The skin was the most affected site, with mild to moderate reactions. Female gender, a history of doctor-diagnosed asthma, drug allergy, food allergy and psychiatric diseases were significant risk factors. The sensitivities of SPTs and early readings of IDTs in the diagnosis of immediate reactions were 0 and 20%, respectively, and the specificities were 94.6 and 91.4%, respectively. For early readings of IDTs, the positive predictive value (PPV) and negative predictive value (NPV) were 40 and 80%, respectively. For nonimmediate reactions, the sensitivities of delayed readings of IDTs and PTs were 14.3 and 25%, respectively; specificity was 100% for both tests. The PPV was 100% for both of these tests, and the NPVs were 85.4 and 82.4%, respectively.
Our findings are comparable with the incidence, profile and risk factors associated with CM hypersensitivity reported previously. Skin testing with CMs has a high specificity, but its role in diagnosis is limited due to low sensitivity.
对比剂（CM）过敏可能很常见且很严重。
评估 CM 过敏的患病率、与其相关的危险因素，以及皮肤试验在其诊断中的作用。
对在 1 年期间行 CT 检查的患者进行了结构化问卷调查。对 CM 反应者（n=24）进行了 CM 皮肤试验，包括皮肤点刺试验（SPT）、皮内试验（IDT）和斑贴试验（PT）。志愿者中，那些耐受 CM 暴露或从未接触过任何 CM 的人作为对照（n=37）。
共纳入 1131 例患者（630 例女性和 501 例男性；平均年龄 55±14.2 岁）。有 CM 反应的既往史和现病史患者分别为 33/1131（2.92%）和 8/1105（0.72%）。皮肤是最常受累的部位，表现为轻至中度反应。女性、有医生诊断的哮喘、药物过敏、食物过敏和精神疾病病史是显著的危险因素。SPT 和 IDT 早期读数对即刻反应的诊断的敏感性分别为 0 和 20%，特异性分别为 94.6%和 91.4%。对于 IDT 的早期读数，阳性预测值（PPV）和阴性预测值（NPV）分别为 40%和 80%。对于非即刻反应，IDT 和 PT 的延迟读数的敏感性分别为 14.3%和 25%；两种检测的特异性均为 100%。这两种检测的 PPV 均为 100%，NPV 分别为 85.4%和 82.4%。
我们的研究结果与先前报道的 CM 过敏的发生率、特征和危险因素相似。CM 皮肤试验具有较高的特异性，但由于敏感性低，其在诊断中的作用有限。
