A Clinical Study of Cutaneous Adverse Reactions to Nonionic Contrast Media in Korea
1
조회
0
다운로드
8
인용
0
참고문헌
키워드
초록
Background: The use of intravenous contrast media (CM) has increased for the diagnosis of several diseases. The newly developed low osmolar nonionic contrast agents cause significantly decreased adverse reactions than the higher osmolar ones. However, adverse reactions may still occur,ranging in severity from minor side effects to severe complications. However, there have been few reports about cutaneous adverse reactions (CARs) to nonionic monomer CM. Objective: The purpose of this study was to evaluate clinical features of CAR to intravenous nonionic monomer CM. Methods: A total 47,338 examinees underwent intravenous iodinated contrast-enhanced computed tomography scan using nonionic monomer CM. Among the adverse reactions to the CM, we divided them into cutaneous or noncutaneous and immediate (＜1 hr) or late (≥1 hr) adverse reactions. Results: Adverse reactions were noted in 62 cases out of the total 47,338 cases; 50 cases (80.7%) were categorized CARs. Among them, there were 24 male and 26female patients. There was no significant difference between the sexes, and CARs occurred in all age groups. The highest occurrence was in the age range of 50∼59 years. CARs included urticaria (78%), angioedema (10%), maculopapular rash (8%), erythema (2%), and pruritus without rash (2%). Immediate reactions were 92% (46 cases), while late reactions were 8% (4 cases). Conclusion: CARs to nonionic monomer CM accounted for most of the adverse reactions (80.7%) and urticaria was the most common.
Abstract
Background: The use of intravenous contrast media (CM) has increased for the diagnosis of several diseases. The newly developed low osmolar nonionic contrast agents cause significantly decreased adverse reactions than the higher osmolar ones. However, adverse reactions may still occur,ranging in severity from minor side effects to severe complications. However, there have been few reports about cutaneous adverse reactions (CARs) to nonionic monomer CM. Objective: The purpose of this study was to evaluate clinical features of CAR to intravenous nonionic monomer CM. Methods: A total 47,338 examinees underwent intravenous iodinated contrast-enhanced computed tomography scan using nonionic monomer CM. Among the adverse reactions to the CM, we divided them into cutaneous or noncutaneous and immediate (＜1 hr) or late (≥1 hr) adverse reactions. Results: Adverse reactions were noted in 62 cases out of the total 47,338 cases; 50 cases (80.7%) were categorized CARs. Among them, there were 24 male and 26female patients. There was no significant difference between the sexes, and CARs occurred in all age groups. The highest occurrence was in the age range of 50∼59 years. CARs included urticaria (78%), angioedema (10%), maculopapular rash (8%), erythema (2%), and pruritus without rash (2%). Immediate reactions were 92% (46 cases), while late reactions were 8% (4 cases). Conclusion: CARs to nonionic monomer CM accounted for most of the adverse reactions (80.7%) and urticaria was the most common.
참고문헌 (27)
- Bush WH, "Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment", AJR Am J Roentgenol, 157, pp.1153~1161 (1991)
- Christiansen C, "Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations", Eur Radiol, 10, pp.1965~1975 (2000)
- Brockow K, "Management of hypersensitivity reactions to iodinated contrast media", Allergy, 60, pp.150~158 (2005)
- Maddox TG, "Adverse reactions to contrast material: recognition, prevention, and treatment", Am Fam Physician, 66, pp.1229~1234 (2002)
- Katayama H, "Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media", Radiology, 175, pp.621~628 (1990)
- Cochran ST, "Trends in adverse events after IV administration of contrast media", AJR Am J Roentgenol, 176, pp.1385~1388 (2001)
- Mortelé KJ, "Universal use of nonionic iodinated contrast medium for CT: evaluation of safety in a large urban teaching hospital", AJR Am J Roentgenol, 184, pp.31~34 (2005)
- Wang CL, "Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions", AJR Am J Roentgenol, 191, pp.409~415 (2008)
- Meth MJ, "Current understanding of contrast media reactions and implications for clinical management", Drug Saf, 29, pp.133~141 (2006)
- 김선신, "일반인에서 컴퓨터 단층촬영에 사용되는 조영제 과민반응의 발생빈도와 임상양상", 천식 및 알레르기, 27(3), pp.157~161 (2007), 대한천식알레르기학회
- Morcos SK, "Adverse reactions to iodinated contrast media", Eur Radiol, 11, pp.1267~1275 (2001)
- Wendt-Nordahl G, "Intravenous contrast media in uroradiology: evaluation of safety and tolerability in almost 50,000 patients", Med Princ Pract, 15, pp.358~361 (2006)
- Pedersen SH, "Late allergylike reactions following vascular administration of radiography contrast media", Acta Radiol, 39, pp.344~348 (1998)
- Hosoya T, "Delayed adverse reactions to iodinated contrast media and their risk factors", Radiat Med, 18, pp.39~45 (2000)
- Yoshikawa H, "Late adverse reactions to nonionic contrast media", Radiology, 183, pp.737~740 (1992)
- Laroche D, "Mechanisms of severe, immediate reactions to iodinated contrast material", Radiology, 209, pp.183~190 (1998)
- Mita H, "Detection of IgE antibody to a radiocontrast medium", Allergy, 53, pp.1133~1140 (1998)
- Kvedariene V, "Diagnosis of iodinated contrast media hypersensitivity: results of a 6-year period", Clin Exp Allergy, 36, pp.1072~1077 (2006)
- Brockow K, "Late skin test reactions to radiocontrast medium", J Allergy Clin Immunol, 104, pp.1107~1108 (1999)
- Delgado-Jimenez Y, "Late skin reaction to iodixanol (Visipaque): clinical manifestations, patch test study, and histopathological evaluation", Contact Dermatitis, 55, pp.348~353 (2006)
- Kanny G, "T cell-mediated reactions to iodinated contrast media: evaluation by skin and lymphocyte activation tests", J Allergy Clin Immunol, 115, pp.179~185 (2005)
- Lasser EC, "Pretreatment with corticosteroids to alleviate reactions to intravenous contrast material", N Engl J Med, 317, pp.845~849 (1987)
- Greenberger P, "Administration of radiographic contrast media in high-risk patients", Invest Radiol, 15(6 Suppl), pp.S40~S43 (1980)
- Wolf GL, "Comparison of the rates of adverse drug reactions. Ionic contrast agents, ionic agents combined with steroids, and nonionic agents", Invest Radiol, 26, pp.404~410 (1991)
- Thomsen HS, "Adverse effects of contrast media: incidence, prevention and management", Drug Saf, 19, pp.313~324 (1998)
- Lasser EC, "Pretreatment with corticosteroids to prevent adverse reactions to nonionic contrast media", AJR Am J Roentgenol, 162, pp.523~526 (1994)
- Greenberger PA, "The prevention of immediate generalized reactions to radiocontrast media in high-risk patients", J Allergy Clin Immunol, 87, pp.867~872 (1991)