Hypersensitivity reactions to iodinated contrast media in Italy: a retrospective study. Characteristics of patients and risk factors
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Authors Information
1Allergy Clinic, Genoa, Italy
2Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
3Allergology U.O., Avezzano Hospital, ASL n. 1 Abruzzo, L'Aquila, Italy
4Allergology U.O.C., Polyclinic Hospital San Martino - IRCCS, Genoa, Italy
5Department of Internal Medicine, University of Genoa - Polyclinic Hospital S. Martino - IRCCS, Genoa, Italy
6 Allergy Unit, Castelli di Verbania Hospital, ASL VCO, Verbania, Italy
7Allergy Unit, Fondazione Policlinico A. Gemelli - IRCCS, Rome, Italy
8Department of Radiology, Polyclinic Hospital San Martino - IRCCS, Genoa, Italy
9Internal Medicine U.O., Polyclinic Hospital San Martino - IRCCS, Genoa, Italy
10Internal Medicine and Rheumatology U.O., Rimini Hospital, ASL Romagna, Rimini, Italy
11Allergology S.S.V.D., ASST Spedali Civili di Brescia, Brescia, Italy
12General and Interventistic Radiology U.O., Avezzano Hospital, ASL n. 1 Abruzzo, L'Aquila, Italy
13Allergy Clinic, Casa di Cura Beato Palazzolo, Bergamo, Italy
14 Allergy and Clinical Immunology Unit, S. Giovanni di Dio Hospital, AUSL Toscana Centro, Florence, Italy
15Life and health University S. Raffaele, Milan, Italy
16Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS S. Raffaele Hospital, Milan, Italy
17Department of Radiology, E.O. Galliera, Genoa, Italy
18Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
19Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy
History
Published: 05 July 2021
Accepted: 05 July 2021
Received: 23 May 2021
SUMMARY
Objective. The purpose of the study was to describe the characteristics of patients experiencing hypersensitivity reactions (HRs) to iodinated contrast media (ICM) in a large Italian population and to investigate potential risks factors in order to obtain a risk stratification, helpful in the management of these patients. Methods. Data of 407 patients investigated in 9 Italian Allergy Centers for suspected HRs to ICM were analyzed and compared with a control group of 152 subjects that tolerated one or more ICM-enhanced examinations. The univariate and multivariate logistic regression model was used to evaluate associated factors. Results. The mean age of reactive patients was 61 years and 60% were female; 67% of patients reported immediate reactions and 35% experienced the reaction, more frequently with immediate onset, at the first examination in life. Iomeprol, iopromide and iodixanol were the most frequent culprit agents and 20% of patients showed a positive skin test result. Previous adverse reactions to ICM were reported by 15.6% of patients. The multivariate analysis showed that male gender and age > 65 were associated with ICM reactions as protective factors [ORadja = 0.51; 95% CI: 0.33-0.77 and ORadja = 0.60; 95% CI: 0.39-0.92 respectively]. Cardio-vascular disease [ORadja = 2.06; 95% CI: 1.22-3.50)], respiratory allergy [ORadja = 2.30; 95% CI: 1.09-4.83)] and adverse drug reactions [ORadja = 1.99; 95% CI: 1.05-3.77)] were identified as risk factors for ICM reactions. Food allergy was not significantly associated with reactions [ORadja = 1.51; 5% CI: 0.41-5.56]. Conclusions. This is the largest study on Italian patients experiencing hypersensitivity reactions to ICM. Most results are in line with other studies, showing some association with factors that could influence the incidence of hypersensitivity reactions but not allowing an easy risk stratification.
