Krohne T U, Allam J-P, Novak N, Holz F G
Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
Klinik und Poliklinik für Dermatologie und Allergologie, Universität Bonn, Bonn, Deutschland.
Ophthalmologe. 2016 Dec;113(12):1023-1028. doi: 10.1007/s00347-016-0359-9.
Preoperative disinfection with povidone-iodine results in a significant reduction of the risk for postoperative endophthalmitis and secondary irreversible vision loss in intraocular surgeries and intravitreal injections. Nevertheless, this important measure is often omitted if so-called "iodine allergy" is suspected. We analyze the physiological and allergological basis for the construct of "iodine allergy".
This article is based on a selective literature review using the search term "allergy" in combination with "iodine", "povidone", "indocyanine green", or "seafood".
Iodine is a chemical element and an essential component of the human body. Scientific proof for the existence of an antibody-mediated allergic reaction (type I reaction) and in particular an immunoglobulin (Ig) E‑mediated anaphylaxis against iodine is lacking. Chemical irritations and contact allergies (type IV reaction) induced by iodine-containing disinfectants are not antibody-mediated and do not cause anaphylaxis (type I reaction). The uncommon antibody-mediated allergies against iodine-containing disinfectants, fluorescent dyes, radiocontrast media, or seafood are not directed against the contained iodine itself but against other components of the respective formulation. Thus, allergic cross-reactivities between these different substance groups are not to be expected.
So-called "iodine allergy" is a medical myth lacking a scientific basis and should not result in increased patient risks due to omitted preoperative disinfection.
在眼科手术和玻璃体内注射中，术前使用聚维酮碘进行消毒可显著降低术后眼内炎风险以及继发性不可逆视力丧失的风险。然而，如果怀疑存在所谓的“碘过敏”，这一重要措施常常会被省略。我们分析了“碘过敏”这一概念的生理学和变应性基础。
本文基于一项选择性文献综述，使用搜索词“过敏”并结合“碘”“聚维酮”“吲哚菁绿”或“海鲜”进行检索。
碘是一种化学元素，也是人体的必需成分。缺乏关于存在抗体介导的过敏反应（I型反应），尤其是免疫球蛋白（Ig）E介导的对碘过敏反应的科学证据。含碘消毒剂引起的化学刺激和接触性过敏（IV型反应）并非由抗体介导，也不会引起过敏反应（I型反应）。针对含碘消毒剂、荧光染料、放射性造影剂或海鲜的罕见抗体介导过敏反应并非针对所含的碘本身，而是针对各自制剂中的其他成分。因此，不应预期这些不同物质组之间会发生过敏交叉反应。
所谓的“碘过敏”是一个缺乏科学依据的医学误区，不应因术前消毒的省略而增加患者风险。
