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[对含碘药物和富含碘食物的过敏:碘并非过敏决定因素]

[Allergy to iodinated drugs and to foods rich in iodine: Iodine is not the allergenic determinant].

作者信息

Dewachter Pascale, Mouton-Faivre Claudie

机构信息

Université Paris Descartes Sorbonne Paris Cité, Inserm UMR-S970, AP-HP, hôpital européen Georges-Pompidou, service d'anesthésie-réanimation chirurgicale, 20, rue Leblanc, 75015 Paris, France.

Hôpital de Brabois, consultation d'allergo-anesthésie, 54511 Vandœuvre-lès-Nancy, France; AP-HP, hôpital européen Georges-Pompidou, consultation d'allergo-radiologie, 75015 Paris, France.

出版信息

Presse Med. 2015 Nov;44(11):1136-45. doi: 10.1016/j.lpm.2014.12.008. Epub 2015 Sep 19.

Abstract

"Iodine allergy" does not exist. The concept of "iodine allergy" should be abandoned since it may result in inappropriate measures such as drug, food or environmental eviction. Immediate or non-immediate allergic hypersensitivity to iodinated contrast media is not infrequent. The corresponding allergens have not been identified. Iodine is not involved. Immediate or non-immediate allergic hypersensitivity to povidone iodine is rare. The corresponding allergen is povidone in case of immediate hypersensitivity while nonoxynol might be involved during non-immediate hypersensitivity. Seafood allergens belong to a group of muscle proteins. Immediate drug hypersensitivity or food hypersensitivity is assessed by immediate-reading skin tests while non-immediate drug hypersensitivity is investigated by delayed-reading skin testing. Combined histamine and tryptase measurement is invaluable during the diagnostic approach of immediate hypersensitivity. Other biological tests are being evaluated. Allergic hypersensitivity to iodinated contrast agents does not contraindicate the use of other iodinated drugs.

摘要

“碘过敏”并不存在。“碘过敏”这一概念应予摒弃,因为它可能导致诸如停用药物、食物或避免接触相关环境等不当措施。对碘化造影剂立即或非立即发生的过敏超敏反应并不罕见。相应的过敏原尚未确定。碘并不参与其中。对聚维酮碘立即或非立即发生的过敏超敏反应很少见。在立即超敏反应的情况下,相应的过敏原是聚维酮,而非立即超敏反应时可能涉及壬苯醇醚。海鲜过敏原属于一组肌肉蛋白。立即型药物超敏反应或食物超敏反应通过即时读取皮肤试验进行评估,而非立即型药物超敏反应则通过延迟读取皮肤试验进行研究。在立即超敏反应的诊断过程中,联合检测组胺和类胰蛋白酶非常重要。其他生物学检测正在评估中。对碘化造影剂的过敏超敏反应并不妨碍使用其他含碘药物。

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