• Violeta Kvedariene, Monika Orvydaite, Paulina Petraityte, Justina Rudyte, and Edvardas TamosiunasAlgirdasAFaculty of Medicine, Institute of Biomedical Science, Vilnius, Lithuania.Centre of Radiology and Nuclear Medicine, Vilniaus University Hospital Santaros Klinikos, Vilnius, Lithuania..
• Institute of Clinical Medicine, Clinic of Chest Diseases, Allergology and Immunology, Vilniaus University Hospital Santaros Klinikos, Vilnius, Lithuania.
• Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14766.

BackgroundIodinated contrast media (ICM) is a frequently used compound in radiology. Non-immediate hypersensitivity reactions (HSR) appear when a patient leaves the department and usually are undocumented. True hypersensitivity in this group is rarely proved.MethodsSingle-centre 2014-2018 data were retrospectively analysed. HSR to ICM were classified and investigated according to the time of occurrence (immediate <1 hour, non-immediate >1 hour). ENDA questionnaire and skin tests (prick or intradermal test) were performed according to ENDA/EAACI recommendations.Results69 patients with a clinical history of HSR to ICM were identified, 72.46% were females (n = 50). The average age was 56 (SD ± 13.16) years. Non-immediate HSR occurred in 28.99% (n = 20) patients. The suspected culprit drugs were: iodixanol 20% (n = 4), iopromide 5% (n = 1), diatrizoate 10% (n = 2) and iohexol 10% (n = 2). Among non-immediate HSR 96.00% (n = 19) of patients had skin rashes. A statistically significant correlation was found between the clinical symptoms and the type of reaction (p-value <0.05): isolated skin manifestations mostly occurred in non-immediate HSR 75.00% (n = 15). Only 13.04% (n = 9) of all the patients were proved to be allergic to a certain ICM after the proposed diagnostic workup.ConclusionsOne-third of the hypersensitivity reactions investigated were classified as non-immediate type. Most of them manifested with isolated skin symptoms. The most frequent culprit drug encountered was iodixanol. The overall non-immediate hypersensitivity confirmation rate after diagnostic evaluation was only 15%.© 2021 John Wiley & Sons Ltd.

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