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01-11-2011 | Contrast Media

Late adverse reactions to intravascular iodine based contrast media: an update

Authors: Marie-France Bellin, Fulvio Stacul, Judith A. W. Webb, Henrik S. Thomsen, Sameh K. Morcos, Torsten Almén, Peter Aspelin, Olivier Clement, Gertraud Heinz-Peer, Peter Reimer, Aart van der Molen, on behalf of the Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR)

Published in: European Radiology | Issue 11/2011

Abstract

Definition

Late adverse reactions (LAR) to contrast media (CM) are defined as reactions occurring 1 h to 1 week after exposure.

Need for review

In view of more prospective studies of LAR and new data about their pathophysiology, the Contrast Medium Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) reviewed the literature on LAR and updated their guidelines.

Clinical features and pathology

LAR after CM include symptoms such as nausea, vomiting, headache, itching, skin rash, musculoskeletal pain, and fever. Skin reactions are well-documented LAR to CM with an incidence of approximately 2%–4% after nonionic monomers. LAR are commoner by a factor of three to four after nonionic dimers. The commonest skin reactions are maculopapular rashes, erythema and skin swelling. These reactions are T cell-mediated immune reactions, and the diagnosis may be confirmed using skin tests (patch or delayed reading intradermal). The main risk factors for LAR are a previous reaction to contrast medium, a history of allergy, and interleukin-2 treatment. Most skin reactions are mild or moderate and self-limiting.

Management

Management is symptomatic and similar to the management of other drug-induced skin reactions. To reduce the risk of repeat reactions avoidance of the relevant CM and any cross-reacting agents identified by skin testing is recommended.

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Title: Late adverse reactions to intravascular iodine based contrast media: an update
Authors: Marie-France Bellin
Fulvio Stacul
Judith A. W. Webb
Henrik S. Thomsen
Sameh K. Morcos
Torsten Almén
Peter Aspelin
Olivier Clement
Gertraud Heinz-Peer
Peter Reimer
Aart van der Molen
on behalf of the Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR)
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: European Radiology / Issue 11/2011
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-011-2200-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Late adverse reactions to intravascular iodine based contrast media: an update

Abstract

Definition

Need for review

Clinical features and pathology

Management

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Definition

Need for review

Clinical features and pathology

Management

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