Although rare, IgE-mediated reactions to gadolinium derivatives have been reported. Another type of contrast media, gadolinium derivatives, is used used for magnetic resonance imaging.
The ICM to be administered will therefore be chosen depending on the results of these tests, the ICM that induced the reaction (when known), the severity of the reaction, the availability of alternative ICM, and the information available on potential ICM cross-reactivity.
#Doble contraste en radiologia skin#
Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions. Maculopapular rash is the most common skin feature of nonimmediate reactions (30%-90%). The most common symptoms of immediate reactions are erythema and urticaria with or without angioedema, which appear in more than 70% of patients. The risk factors for immediate reactions include poorly controlled bronchial asthma, concomitant medication (eg, angiotensin-converting enzyme inhibitors, ß-blockers, and proton-pump inhibitors), rapid administration of the ICM, mastocytosis, autoimmune diseases, and viral infections. Hypersensitivity reactions can appear within the first hour after administration (immediate reactions) or from more than 1 hour to several days after administration (nonimmediate or delayed reactions). The prevalence of allergic reactions to iodinated contrast media (ICM) is estimated to be 1:170 000, that is, 0.05%-0.1% of patients undergoing radiologic studies with ICM (more than 75 million examinations per year worldwide). The panel of experts who produced this consensus document developed a research protocol based on a review of the literature. The objective of these guidelines is to ensure efficient and effective clinical practice.
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