Fok Jie Shen, Smith William B
aDepartment of General Medicine bDepartment of Clinical Immunology and Allergy, Flinders Medical Centre, Bedford Park cDepartment of Clinical Immunology and Allergy, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Curr Opin Allergy Clin Immunol. 2017 Aug;17(4):241-246. doi: 10.1097/ACI.0000000000000371.
Gadolinium-based contrast agents (GBCAs) have been utilized since the late 1980s to enhance the diagnostic value of MRI studies. They are known to have excellent safety profile and serious adverse reactions are uncommon despite widespread global use. However, immediate hypersensitivity reactions are well described in the literature, with urticaria the most common manifestation. Anaphylaxis can occur, though fatality is extremely rare. This review explores the incidence of GBCA-related hypersensitivity reactions and highlights potential risk factors.
Emerging evidence suggests that immediate hypersensitivity reactions to GBCAs can be IgE-mediated. Skin testing may be informative in confirmation of causality and revealing cross-reactivity patterns.
GBCA hypersensitivity is infrequent but can be serious. Familiarity with management of acute hypersensitivity reactions may be lifesaving. Appropriate use of diagnostic testing can be used to guide future management of patients who have suffered from such reactions.
自20世纪80年代末以来，钆基造影剂（GBCAs）已被用于提高MRI研究的诊断价值。已知它们具有良好的安全性，尽管在全球广泛使用，但严重不良反应并不常见。然而，文献中对即刻过敏反应有充分描述，荨麻疹是最常见的表现。过敏反应可能发生，尽管致死极为罕见。本综述探讨了GBCA相关过敏反应的发生率，并强调了潜在风险因素。
新出现的证据表明，对GBCAs的即刻过敏反应可能由IgE介导。皮肤试验可能有助于确认因果关系并揭示交叉反应模式。
GBCA过敏反应不常见，但可能很严重。熟悉急性过敏反应的处理可能会挽救生命。适当使用诊断测试可用于指导曾发生此类反应的患者的未来管理。
