PMID- 34734510
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231108
IS  - 2092-7355 (Print)
IS  - 2092-7363 (Electronic)
IS  - 2092-7355 (Linking)
VI  - 13
IP  - 6
DP  - 2021 Nov
TI  - Skin Test Results and Cross-Reactivity Patterns in IgE- and T-Cell-Mediated 
      Allergy to Gadolinium-Based Contrast Agents.
PG  - 933-938
LID - 10.4168/aair.2021.13.6.933 [doi]
AB  - Allergies to gadolinium-based contrast agents (GBCAs) are rare and manifest 
      usually as an immediate drug hypersensitivity reaction (DHR), compatible with an 
      immunoglobulin E (IgE)-mediated mechanism. Although the molecular structures of 
      GBCA show some similarities and are either linear or macrocyclic, the frequency 
      and pattern of cross-reactivity remain unclear. However, cross-reactivity has 
      been described. The aim of this investigation was to assess cross-reactivity in 
      patients with GBCA allergy based on skin tests and exposure. We retrospectively 
      evaluated a total of 28 cases with a proven allergy to a GBCA, including 11 from 
      the database of the allergy division of the Inselspital, Bern and 17 published 
      cases from the literature, retrieved with a PubMed-MEDLINE search. The majority 
      of cases were immediate DHR, with 8/11 cases from the database (72.7%) and 16/17 
      published cases (94.1%). In both groups macrocyclic GBCA were most often 
      identified as causative drugs. A cross-reactivity based on skin test results was 
      found in 2 out of 11 database cases (18.2%) and in 6 out of 17 literature cases 
      (35.3%). Cross-reactivity occurred within macrocyclic GBCA in 1/11 database cases 
      and 3/17 literature cases, and included both macrocyclic and linear GBCA in 1/11 
      and 4/17 subjects. There was no cross sensitization among linear GBCA. Skin 
      test-negative GBCA were well tolerated, even in cases with sensitization to 
      linear and macrocyclic GBCA. Overall, cross-reactivity in GBCA allergy is rare 
      (approximately 29%), and may occur among macrocyclic GBCA or in between 
      macrocyclic and linear GBCA. IgE to linear GBCA seems to be rarely 
      cross-reactive. Skin test is helpful in identifying safe alternatives, as no 
      reaction to skin test-negative GBCA was observed.
CI  - Copyright (c) 2021 The Korean Academy of Asthma, Allergy and Clinical Immunology * 
      The Korean Academy of Pediatric Allergy and Respiratory Disease.
FAU - Grueber, Hans-Peter
AU  - Grueber HP
AD  - Radiology Division, Spital Region Oberaargau, Spital Langenthal, Langenthal, 
      Switzerland.
FAU - Helbling, Arthur
AU  - Helbling A
AD  - Division of Allergology and Clinical Immunology, Department of Pneumology, 
      Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
FAU - Joerg, Lukas
AU  - Joerg L
AUID- ORCID: 0000-0003-1512-4279
AD  - Division of Allergology and Clinical Immunology, Department of Pneumology, 
      Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 
      lukas.joerg@insel.ch.
LA  - eng
PT  - Journal Article
PL  - Korea (South)
TA  - Allergy Asthma Immunol Res
JT  - Allergy, asthma & immunology research
JID - 101518382
PMC - PMC8569030
OTO - NOTNLM
OT  - Gadolinium-based contrast agent (GBCA)
OT  - IgE
OT  - T-cell
OT  - allergy
OT  - anaphylaxis
OT  - contrast media
OT  - cross-reaction
OT  - drug hypersensitivity
OT  - skin test
COIS- There are no financial or other issues that might lead to conflict of interest.
EDAT- 2021/11/05 06:00
MHDA- 2021/11/05 06:01
PMCR- 2021/11/01
CRDT- 2021/11/04 06:46
PHST- 2020/10/08 00:00 [received]
PHST- 2021/03/06 00:00 [revised]
PHST- 2021/03/23 00:00 [accepted]
PHST- 2021/11/04 06:46 [entrez]
PHST- 2021/11/05 06:00 [pubmed]
PHST- 2021/11/05 06:01 [medline]
PHST- 2021/11/01 00:00 [pmc-release]
AID - 13.933 [pii]
AID - 10.4168/aair.2021.13.6.933 [doi]
PST - ppublish
SO  - Allergy Asthma Immunol Res. 2021 Nov;13(6):933-938. doi: 
      10.4168/aair.2021.13.6.933.