PMID- 9769830
OWN - NLM
STAT- MEDLINE
DCOM- 19981030
LR  - 20220408
IS  - 0033-8419 (Print)
IS  - 0033-8419 (Linking)
VI  - 209
IP  - 1
DP  - 1998 Oct
TI  - Mechanisms of severe, immediate reactions to iodinated contrast material.
PG  - 183-90
AB  - PURPOSE: To measure and elucidate the mechanisms of presumed mediators of 
      unexpected severe, immediate reactions to iodinated contrast materials. MATERIALS 
      AND METHODS: In a multicenter study, 20 patients with mild to severe reactions to 
      iodinated contrast material and 20 control subjects without reactions were 
      evaluated. Ionic contrast material was associated with 18 (90%) of 20 reactions. 
      Concentrations of plasma histamine, tryptase, urinary methylhistamine, specific 
      immunoglobulin E (IgE) against ioxitalamate or ioxaglate, and the anaphylatoxins 
      C3a and C4a were measured with radioimmunoassays; complement C3 and C4 levels 
      were measured with nephelometry. RESULTS: Histamine levels were increased in 14 
      patients; tryptase levels, in 16; and methylhistamine levels, in six. Histamine 
      and tryptase values correlated with the severity of the reaction (P < .02 and P < 
      .004, respectively). Significantly higher levels of specific IgE against 
      ioxaglate (P < .005) and ioxitalamate (P = .045) were found in patients. No 
      differences were found for complement fractions. Skin test results in two 
      patients with life-threatening reactions were positive for the administered 
      contrast material. CONCLUSION: Histamine release and mast cell triggering are 
      related to severe reactions. An IgE-related mechanism is strongly suspected. 
      Radiologists should be trained to identify and treat anaphylactic shock in 
      patients who react to iodinated contrast material.
FAU - Laroche, D
AU  - Laroche D
AD  - Laboratory of Medical Physics, Centre Hospitalier Regional Universitaire, Caen, 
      France.
FAU - Aimone-Gastin, I
AU  - Aimone-Gastin I
FAU - Dubois, F
AU  - Dubois F
FAU - Huet, H
AU  - Huet H
FAU - Gerard, P
AU  - Gerard P
FAU - Vergnaud, M C
AU  - Vergnaud MC
FAU - Mouton-Faivre, C
AU  - Mouton-Faivre C
FAU - Gueant, J L
AU  - Gueant JL
FAU - Laxenaire, M C
AU  - Laxenaire MC
FAU - Bricard, H
AU  - Bricard H
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Radiology
JT  - Radiology
JID - 0401260
RN  - 0 (Complement C3)
RN  - 0 (Complement C4)
RN  - 0 (Contrast Media)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
CIN - Radiology. 1998 Oct;209(1):35-6. PMID: 9769809
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anaphylaxis/chemically induced/immunology
MH  - Complement C3/analysis
MH  - Complement C4/analysis
MH  - Contrast Media/administration & dosage/*adverse effects
MH  - Drug Hypersensitivity/*etiology/immunology
MH  - Female
MH  - France
MH  - Histamine Release/immunology
MH  - Humans
MH  - Hypersensitivity, Immediate/*chemically induced/immunology
MH  - Immunoglobulin E/blood
MH  - Male
MH  - Middle Aged
MH  - Skin Tests
MH  - Time Factors
EDAT- 1998/10/14 00:00
MHDA- 1998/10/14 00:01
CRDT- 1998/10/14 00:00
PHST- 1998/10/14 00:00 [pubmed]
PHST- 1998/10/14 00:01 [medline]
PHST- 1998/10/14 00:00 [entrez]
AID - 10.1148/radiology.209.1.9769830 [doi]
PST - ppublish
SO  - Radiology. 1998 Oct;209(1):183-90. doi: 10.1148/radiology.209.1.9769830.