Single-center experience in skin allergy testing to iodinated contrast media

Abstract

Background: Iodinated contrast media (ICM) highlights anatomical boundaries and normal and pathological findings during radiological examinations. Although modern iodinated contrast agents are safe and rarely cause severe adverse reactions, there are still cases where a radiological examination with intravenous contrast material is either not performed, or premedication is administered due to a patient's reported iodine allergy. Most of the adverse reactions are not life-threatening, but 1 in 2500 patients may experience a severe and potentially life-threatening reaction due to the injected contrast material. The manifestation of hypersensitivity reactions may depend on the patient's age, gender, comorbidities, previous hypersensitivity reactions, other allergies, and some medications used. Our study aimed to compare skin allergic reactions in patient groups stratified by sex, comorbidities, and atopy.Method: A retrospective analysis of medical records from the Hospital of Lithuanian University of Health Sciences, Kauno klinikos data register was made. The study cohort comprised 117 patients,of whom 93 were females (age 34–85, median – 66) and 24 males (age 38–79, median – 61). All subjects underwent skin prick tests and intradermal testing for ICM with the culprit (when known)and with the ICM commonly used in our hospital nonionic dimers(iodixanol) and nonionic monomers (iohexol, iopromide) between 2019 and 2023. Results: Positive test reactions were observed in seven females, constituting 7.5% of all examined females, and in 1 male, accounting for 4.2% of all males examined (p = 0.561). Positive reactions were observed only in individuals with comorbidities, that is, eight patients, representing 6.8% of all our subjects (p = 0.322). Five individuals without atopy also had positive skin tests for ICM (4.3% of all individuals) (p = 0.752). Conclusion: There is no significant difference in skin test positivity to ICM between women and men, patients with or without comorbidities, and individuals with or without atopy. However, there was a tendency for women to have more positive skin allergic reactions to ICM than men, as well as patients with comorbidities. Meanwhile, patients' atopy did not influence skin allergy test results in our study.Conflicts of Interest: The authors did not specify any links of interest.