1 Department of Radiology, Northwestern Memorial Hospital, Northwestern University-Feinberg School of Medicine, 676 N Saint Clair St, Ste 800, Chicago, IL 60611.
AJR Am J Roentgenol. 2018 Apr;210(4):715-719. doi: 10.2214/AJR.17.18655. Epub 2018 Feb 7.
The objective or our study was to assess the incidence rate and clinical characteristics of allergiclike reactions in patients who received both nonionic iodinated contrast medium (ICM) and gadolinium-based contrast medium (GBCM).
Acute allergiclike reactions in patients who received both ICM and GBCM to nonionic ICM or GBCM injections during a 5-year period were analyzed. Allergy preparation was not administered when patients received a different type of contrast material. Acute allergiclike reactions to both ICM and GBCM were evaluated.
Of 302,858 contrast injections (155,234 ICM and 147,624 GBCM) during a 5-year period, 1006 (752 ICM and 254 GBCM) acute allergiclike contrast reactions were reported. The overall rate of reaction to ICM was 0.48% (95% CI, 0.45-0.52%), and the overall rate of reaction to GBCM was 0.17% (95% CI, 0.15-0.19%). A total of 19,237 patients received at least one ICM injection and one GBCM injection, with a total of 56,310 injections (19,237 initial injections and 37,073 subsequent injections). Nine patients had reactions to both ICM and GBCM with the primary reaction rate of 9/19,237 (incidence rate, 0.047%; 95% CI, 0.044-0.050%), and the secondary reaction rate of 9/37,073 (incidence rate, 0.024%; 95% CI, 0.023-0.026%). All secondary reactions in patients who had a reaction to both ICM and GBCM were mild. None of the patients required medication for the treatment of the secondary reaction.
An allergiclike reaction to both nonionic ICM and GBCM was an extremely rare event that presented as a mild acute reaction without significant clinical consequences despite the fact that an allergy preparation was not administered.
我们的研究目的是评估同时使用非离子型碘造影剂（ICM）和钆基造影剂（GBCM）的患者中过敏样反应的发生率和临床特征。
分析了 5 年内同时接受非离子型 ICM 和 GBCM 注射的患者发生的急性过敏样反应。当患者接受不同类型的造影剂时，不给予过敏准备。评估了对 ICM 和 GBCM 的急性过敏样反应。
在 5 年内进行的 302858 次造影剂注射（155234 次 ICM 和 147624 次 GBCM）中，报告了 1006 次（752 次 ICM 和 254 次 GBCM）急性过敏样造影剂反应。对 ICM 的总体反应率为 0.48%（95%CI，0.45-0.52%），对 GBCM 的总体反应率为 0.17%（95%CI，0.15-0.19%）。共有 19237 名患者接受了至少一次 ICM 注射和一次 GBCM 注射，共进行了 56310 次注射（19237 次初始注射和 37073 次后续注射）。9 名患者对 ICM 和 GBCM 均有反应，主要反应率为 9/19237（发生率为 0.047%；95%CI，0.044-0.050%），二次反应率为 9/37073（发生率为 0.024%；95%CI，0.023-0.026%）。对 ICM 和 GBCM 均有反应的患者的所有二次反应均为轻度。没有患者需要药物治疗二次反应。
对非离子型 ICM 和 GBCM 的过敏样反应是一种极其罕见的事件，表现为轻度急性反应，尽管未给予过敏准备，但无明显临床后果。
