Iordache Andrei Mihai, Docea Anca Oana, Buga Ana Maria, Mitrut Radu, Albulescu Dana, Zlatian Ovidiu, Ianosi Simona, Ianosi Gabriel, Neagoe Daniela, Sifaki Maria, Rogoveanu Otilia Constantina, Branisteanu Daciana Elena, Calina Daniela
Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Exp Ther Med. 2019 Feb;17(2):1113-1124. doi: 10.3892/etm.2018.7056. Epub 2018 Dec 5.
Contrast agents are used in radiology to increase the sensibility and specificity of radiological techniques. Some of these compounds have side effects that include organ toxicity (with kidney being the most affected organ) and hypersensitivity reactions. We performed multiple PubMed searches from January, 2008 to January, 2018 for studies regarding adverse reactions to compounds used as contrast agents in imagistic techniques. The initial research identified 929 records written in English. After further excluding 223 non-human studies, 292 articles that had irrelevant designs as reviews, meta-analysis, commentaries, editorials and case reports, 414 studies were selected for retrieval. After reading the abstracts, we excluded 363 studies as they had little relevance to the study. In total, 51 full-articles were assessed for eligible studies to be included. Finally, 20 articles were included in the analysis. In our systematic literature search the incidence of overall skin immediate reactions to iodinated contrast media (ICM) had an incidence between 1.15 and 0.12%, depending on the cohort analyzed in the studies. The percentage of cutaneous manifestations in the cohort that experienced immediate hypersensitivity reactions was between 33.33 and 87.7%. The most frequent skin manifestations were urticaria, rashes, pruritus and limited facial edema. Non-iodinated contrast agents have a safer profile compared with ICM, the incidence of immediate adverse reactions being very low in gadolinium-based contrast agents and other agents used for contrast-enhanced ultrasound. The incidence of delayed reactions was between 10.1 and 0.03%. In the studies analyzed by us the main adverse reactions due to delayed hypersensitivity phenomena were cutaneous manifestations that were present between 70.27 and 100% of the cases. Regarding the risk factors for developing immediate adverse reactions, being female was a predisposing factor accompanied by history of allergy and history of reactions to contrast media. An accurate anamnesis of the patients and a correctly conducted pretreatment can limit the incidence and the severity of the adverse reactions and also can avoid the life occurrence of life-threatening reactions.
造影剂用于放射学领域，以提高放射技术的敏感性和特异性。其中一些化合物具有副作用，包括器官毒性（肾脏是受影响最严重的器官）和过敏反应。我们在2008年1月至2018年1月期间对PubMed进行了多次检索，以查找有关成像技术中用作造影剂的化合物不良反应的研究。初步检索共识别出929篇英文记录。在进一步排除223项非人类研究、292篇设计不相关的综述、荟萃分析、评论、社论和病例报告后，选择了414项研究进行检索。阅读摘要后，我们排除了363项与研究相关性不大的研究。总共评估了51篇全文，以确定符合纳入标准的研究。最后，20篇文章被纳入分析。在我们的系统文献检索中，根据研究中分析的队列不同，对碘化造影剂（ICM）发生皮肤即刻反应的总体发生率在1.15%至0.12%之间。经历即刻过敏反应的队列中皮肤表现的百分比在33.33%至87.7%之间。最常见的皮肤表现是荨麻疹、皮疹、瘙痒和局限性面部水肿。与ICM相比，非碘化造影剂的安全性更高，基于钆的造影剂和其他用于超声造影增强的造影剂发生即刻不良反应的发生率非常低。迟发反应的发生率在10.1%至0.03%之间。在我们分析的研究中，迟发性过敏现象导致的主要不良反应是皮肤表现，在70.27%至100%的病例中出现。关于发生即刻不良反应的危险因素，女性是一个易感因素，同时伴有过敏史和造影剂反应史。对患者进行准确的问诊和正确的预处理可以降低不良反应的发生率和严重程度，还可以避免危及生命的反应发生。
