Sorbonne Universités, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Centre d'Immunologie et des Maladies Infectieuses, INSERM U1135, Paris, France.
Sorbonne Universités, Service de Dermatologie et d'Allergologie, Hôpital Tenon, Paris HUEP, APHP, Paris, France.
J Allergy Clin Immunol Pract. 2021 Aug;9(8):3041-3050. doi: 10.1016/j.jaip.2021.02.060. Epub 2021 Mar 20.
Drug reactions with eosinophilia and systemic symptoms (DRESSs) and acute generalized exanthematous pustulosis (AGEP) are potentially severe cutaneous adverse drug reactions.
To describe the clinical findings and sensitization profiles of DRESS and AGEP patients who had been administered iodinated contrast media (ICM).
All adult patients in the dermatologist's French Investigators for Skin Adverse Reactions to Drugs (FISARD) network diagnosed with a DRESS or AGEP highly suspected to have been caused by an ICM were included retrospectively.
Thirteen DRESS patients and 19 AGEP patients who had been administered ICM were included, and the median delay in DRESS and AGEP occurrence after ICM administration was short, 4 and 1 days, respectively. Five AGEP patients had systemic involvement. A high cosensitization rate (46%) was observed among the DRESS patients, mainly with beta-lactam antibiotics. Overall, 77% of our patients were sensitized to several ICM. Patch tests identified the suspected ICM for 21 cases (72%). The retrospective nature, the limited number of subjects, the absence of a control group of healthy individuals, and the lack of detailed information on previous exposure to sensitizing drugs are limitations of this study.
We report a large series of DRESSs and AGEPs related to ICM administration. Skin tests appear useful for diagnosis and potentially to identify alternative ICM.
药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）和急性全身性发疹性脓疱病（AGEP）是潜在严重的药物不良反应。
描述接受碘造影剂（ICM）治疗的 DRESS 和 AGEP 患者的临床发现和致敏谱。
回顾性纳入皮肤科医生法国药物皮肤不良反应调查员（FISARD）网络中诊断为 DRESS 或 AGEP 的所有成人患者，高度怀疑由 ICM 引起。
纳入了 13 例 DRESS 患者和 19 例接受 ICM 治疗的 AGEP 患者，DRESS 和 AGEP 发生在 ICM 治疗后的中位时间分别为 4 天和 1 天。5 例 AGEP 患者有全身受累。DRESS 患者的高共致敏率（46%）主要与β-内酰胺类抗生素有关。总体而言，77%的患者对几种 ICM 致敏。斑贴试验鉴定了 21 例（72%）疑似 ICM。该研究的局限性包括回顾性、受试者数量有限、缺乏健康个体对照组以及缺乏致敏药物的详细信息。
我们报告了一系列与 ICM 给药相关的 DRESS 和 AGEP。皮肤试验似乎对诊断和潜在识别替代 ICM 有用。
