Department of Immunology and Allergy, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Başıbüyük mah. Maltepe, Istanbul, Turkey.
Department of Pulmonology, Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey.
Radiol Med. 2016 Aug;121(8):660-6. doi: 10.1007/s11547-016-0646-1. Epub 2016 Apr 27.
Previous hypersensitivity reactions to contrast media (CM), atopy, atopic disease, drug allergy, and age (20-29 or >55) are risk factors for CM hypersensitivity reactions. Our aim was to evaluate whether these risk factors should prompt skin testing for diagnosing CM allergy.
The study was conducted among patients referred for allergy testing with CM. Skin tests were performed with non ionic or gadolinium CM, recommended by a radiologist. After completion of tests patients were telephonically queried on their symptoms of reactions.
151 risk patients (53 men, 98 women; mean age 55.2) were included in the study. Only 13 (9 %) had a history of hypersensitivity reaction to CM. Compared with the other patients, atopy was significantly more common in patients with a history of CM hypersensitivity reactions. Female gender and mean age were also higher, but not significant. All of the tests with CMs were negative. Only one patient reported urticaria within 1-2 min after administration of CM (telephonically).
Atopy can increase the risk of CM allergy. However, skin tests with CMs may be inefficient, unnecessary, and time-consuming, except in cases with a history of CM allergy. Premedication protocols appear to be beneficial in patients with a history of CM allergy and cannot be recommended for patients with well-controlled asthma, rhinitis, atopic dermatitis or history of drug allergy.
先前对造影剂（CM）的过敏反应、特应性、特应性疾病、药物过敏和年龄（20-29 岁或>55 岁）是 CM 过敏反应的危险因素。我们的目的是评估这些危险因素是否应该促使进行皮肤试验以诊断 CM 过敏。
该研究在因 CM 过敏而接受过敏测试的患者中进行。皮肤试验使用非离子型或钆型 CM 进行，由放射科医生推荐。测试完成后，通过电话询问患者反应症状。
共纳入 151 例有风险的患者（53 名男性，98 名女性；平均年龄 55.2 岁）。仅有 13 例（9%）有 CM 过敏反应史。与其他患者相比，有 CM 过敏反应史的患者特应性明显更常见。女性性别和平均年龄也更高，但无统计学意义。所有 CM 测试均为阴性。仅有 1 例患者在 CM 给药后 1-2 分钟内报告荨麻疹（电话询问）。
特应性可增加 CM 过敏的风险。然而，CM 皮肤试验可能效率低下、不必要且耗时，除了有 CM 过敏史的患者。对于有 CM 过敏史的患者，预先用药方案似乎是有益的，但不能推荐用于哮喘、鼻炎、特应性皮炎或药物过敏控制良好的患者。
