Document Detail

The role of iodine in hypersensitivity reactions to radio contrast media.
MedLine Citation:
PMID:  20210815     Owner:  NLM     Status:  In-Process    
INTRODUCTION: Hypersensitivity reactions to iodinated radio contrast media (RCM) are either immediate-type (IT) or delayed reactions (DT). In IT, the pathomechanism is unclear. In DT, delayed positive patch (PT) and intradermal tests (IDT) and RCM-specific T cells suggest a T cell-mediated mechanism. In both, the role of iodine has not been clarified; however, patients are often labelled as 'iodine allergic'. Occasionally, positive skin tests to iodine-containing drugs are observed. OBJECTIVE: We investigated the presence of hypersensitivity to iodine in patients with a history of hypersensitivity reactions to RCM. METHODS: Nineteen patients with a history of IT (n=9) or DT (n=10) to RCM were investigated. Skin prick tests, IDT and PT with several RCM and iodine formulations were carried out. All underwent oral provocation with Lugol's solution (LS). Two patients each with iodine mumps, contact dermatitis to iodized antiseptics and chronic idiopathic urticaria served as control or proof of concept. RESULTS: In the IT group, skin tests were positive in three out of nine patients to one RCM. One patient with negative skin tests reacted twice to oral iodine with urticaria. In the DT group, sensitization to one or several RCM was identified in 10 out of 10 patients. In seven out of 10 patients, additional sensitizations to the iodine formulations were found. Two patients developed a mild exanthema after oral provocation with LS. CONCLUSION: We have previously demonstrated in patients with iodine mumps that an oral challenge with LS is a valid means to elicit hypersensitivity reactions to iodine. In 19 patients, we showed that iodine is rarely the eliciting agent in hypersensitivity reactions to RCM. Only one patient with a late urticaria to an RCM with a late urticaria to LS and two patients with DT and broad sensitization to all RCM tested reacted to LS with an exanthema. In most cases, more likely the RCM molecules and not iodine are the eliciting compounds.
K Scherer; T Harr; S Bach; A J Bircher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  40     ISSN:  1365-2222     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  468-75     Citation Subset:  IM    
Allergy Unit, Department of Dermatology, University Hospital Basel, Basel, Switzerland.
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Comment In:
Clin Exp Allergy. 2010 May;40(5):697-9   [PMID:  20214661 ]

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