• Min Jae Cha, Dong Yoon Kang, Whal Lee, Soon Ho Yoon, Young Hun Choi, Jun Soo Byun, Jongmin Lee, Yun-Hyeon Kim, Ki Seok Choo, Bum Sang Cho, Kyung Nyeo Jeon, Jae-Woo Jung, and Hye-Ryun Kang.
• From the Departments of Radiology (M.J.C., J.S.B.) and Internal Medicine (J.W.J.), Chung-Ang University Hospital, Seoul, Korea; Drug Safety Monitoring Center, Seoul National University Hospital, 101 Jongno-Gu Seoul, 110-744 Korea (D.Y.K., H.R.K.); Departments of Preventive Medicine (D.Y.K.), Radiology (W.L., S.H.Y., Y.H.C.), and Internal Medicine (H.R.K.), Seoul National University College of Medicine, Seoul, Korea; Department of Radiology, Kyungpook National University Hospital, Daegu, Korea (J.L.); Department of Radiology, Chonnam National University Hospital, Gwangju, Korea (Y.H.K.); Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea (K.S.C.); Department of Radiology, Chung-Buk National University Hospital, Chungju, Korea (B.S.C.); Department of Radiology, Gyeongsang National University School of Medicine, Jinju, Korea (K.N.J.); and Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea (H.R.K.).
• Radiology. 2019 Oct 1; 293 (1): 117-124.

AbstractBackground Multicenter studies may be required for establishing guidelines for safe usage of iodinated contrast media (ICM). Purpose To identify the prevalence, patterns, risk factors, and preventive measures for ICM-related hypersensitivity reactions (HSRs). Materials and Methods Between March 2017 and October 2017, a total of 196 081 patients who underwent ICM administration were enrolled from seven participating institutions. The occurrence of HSRs and baseline patient information were recorded. χ2 and Student t test were performed, and logistic regression analyses were used to identify risk factors that predict occurrence and recurrence of HSR. Results Among 196 081 patients (mean age ± standard deviation, 59.1 years ± 16.0; 105 014 men and 91 067 women) who underwent ICM administration, the overall prevalence of HSRs was 0.73% (1433 of 196 081), and severe reactions occurred in 0.01% (17 of 196 081). Conditional logistic regression for patients with HSR (n = 1433) and a control group (1:1 matched group for age, sex, ICM product, and institution) demonstrated that a patient's previous individual history of an ICM-related HSR (adjusted odds ratio [OR], 198.8; P < .001), hyperthyroidism (adjusted OR, 3.6; P = .04), drug allergy (adjusted OR, 3.5; P < .001), and other allergic diseases (adjusted OR, 6.8; P < .001) and a family history of ICM-related HSRs (adjusted OR, 14.0; P = .01) were predictors of HSR occurrence. Logistic regression analysis showed that use of premedication with antihistamine (OR, 0.5; P = .01) and change in the generic profile of ICM (OR, 0.5; P < .001) were preventive against recurrent HSR. Conclusion Family history as well as previous individual history of hypersensitivity reactions (HSRs) to iodinated contrast media (ICM) were risk factors for HSR occurrence, suggesting a potential genetic predisposition. A change in the culprit ICM and premedication with antihistamine are useful for reducing the recurrence of HSRs. © RSNA, 2019 Online supplemental material is available for this article.

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