Hypersensitivity reactions to iodinated contrast media

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


Hypersensitivity reactions to iodinated contrast media are a pressing public health issue. Lack of understanding of pathogenetic mechanisms of such reactions leads to unjustified refuse of diagnostic and therapeutic procedures using iodinated contrast agents. Reactions of hypersensitivity to other iodine-containing medications are not a contraindication for use of contrast agents. Skin allergy tests are only performed in the patients who had a history of allergic reactions to iodinated contrast media. Usually it is possible to determine an alternative agent by means of skin tests. Premedication before a contrast-enhanced radiological examination has to be indicated to all patients with previous history of allergic disease.

Full Text

Restricted Access

About the authors

L G Khludova

NRC Institute of Immunology FMBA ofRussia

Email: lg.khludova@gmail.com

T N Myasnikova

NRC Institute of Immunology FMBA ofRussia

V V Smirnov

NRC Institute of Immunology FMBA ofRussia

T V Latysheva

NRC Institute of Immunology FMBA ofRussia

M R Khaitov

NRC Institute of Immunology FMBA ofRussia


  1. Christiansen C. X-ray contrast media-an overview Toxicology. 2005;209(2):185-187. doi: 10.1016/j.tox.2004.12.020.
  2. Katzberg RW, Haller C. Contrast-induced nephrotoxicity: clinical landscape. Kidney Int Suppl. 2006;(100):S3-7. doi: 10.1038/sj.ki.5000366.
  3. Shehadi WH. Adverse reactions to intravascularly administered contrast media. A comprehensive study based on a prospective survey. Am J. Roentgenol Radium Ther Nucl Med. 1975;124:145-152.
  4. Katayama H., Yamaguchi K., Kozuka T., Takashima T., Seez P., Matsuura K. Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. Radiology. 1990;175(3):621-628.
  5. Bush WH, Swanson DP Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment. AJR Am J. Roentgenol. 1991;157(6):1153-1161.
  6. Modi D., Mahyavanshi D., Kotecha J., Dave A., Shah H. Adverse reactions to intravenous iodinated contrast media: a prospective study. International Journal of Basic & Clinical Pharmacology. 2012;1(3):211. doi: 10.5455/2319-2003. ijbcp003712.
  7. Wang C., Cohan R., Ellis J., Caoili E., Wang G., Francis I. Frequency, Outcome, and Appropriateness of Treatment of Nonionic Iodinated Contrast Media Reactions. American Journal of Roentgenology. 2008;191(2):409-415. doi: 10.2214/ajr.07.3421.
  8. Herranz L., Bordas J., Towns-Andrews E., Mendez E., Usobiaga P., Carrascosa JL. Conformational changes in bacteriophage phi 29 connector prevents DNA-binding activity. J. Mol Biol. 1990;213(2):263-273. doi: 10.1016/s0022-2836(05)80189-5.
  9. Morin JP, Boutelet I., Toutain H. et al. Comparative pharmacokinetic and renal accumulation of three contrast agents: ioxitalamic acid, ioxaglic acid and iohexol in the rabbit. Pathol BioI. 1987;35:1215-1220.
  10. Bourin M., Jolliet P., Ballereau F. An Overview of the Clinical Pharmacokinetics of X-Ray Contrast Media. Clinical Phar macokinetics. 1997;32(3):180-193. doi: 10.2165/00003088199732030-00002.
  11. Beaty AD, Lieberman PL, Slavin RG. Seafood allergy and radiocontrast media: are physicians propagating a myth? Am J. Med. 2008;121(2):151-154. doi: 10.1016/s0098-1672(08)79000-3.
  12. Lasser E., Berry C., Talner L. et al. Pretreatment with Corticosteroids to Alleviate Reactions to Intravenous Contrast Material. New England Journal of Medicine. 1987;317(14):845-849. doi: 10.1056/nejm198710013171401.
  13. Morcos S. Acute serious and fatal reactions to contrast media: our current understanding. Br J. Radiol. 2005;78(932):686-693. doi: 10.1259/bjr/26301414.
  14. Lasser E. The Multipotential Pseudoantigenicity of X-Ray Contrast Media. Int Arch Allergy Immunol. 2000;123(4):282-290. doi: 10.1159/000053640.
  15. Brockow K. Immediate and Delayed Reactions to Radiocontrast Media: Is There an Allergic Mechanism? Immunol Allergy Clin North Am. 2009;29(3):453-468. DOI: 10.1016/j. iac.2009.04.001.
  16. Gomez E., Ariza A., Blanca-Lopez N., Torres M. Nonimmediate hypersensitivity reactions to iodinated contrast media. Curr Opin Allergy Clin Immunol. 2013;13(4):345-353. doi: 10.1097/aci.0b013e328362b926.
  17. Peachell P., Morcos S. Effect of radiographic contrast media on histamine release from human mast cells and basophils. Br J. Radiol. 1998;71(841):24-30. DOI: 10.1259/ bjr.71.841.9534695.
  18. Lasser E., Berry C., Mishkin M., Williamson B., Zheutlin N., Silverman J. Pretreatment with corticosteroids to prevent adverse reactions to nonionic contrast media. American Journal of Roentgenology. 1994;162(3):523-526. DOI: 10.2214/ ajr.162.3.8109489.
  19. ACR Manual on Contrast Media. ACR Committee on Drugs and Contrast Media 2018;10.3:102-103. Available from: https://www.acr.org/-/media/ACR/Files/Clinical-Resources/ Contrast_Media.pdf.
  20. Lasser E., Berry C., Talner L. et al. Pretreatment with Corticosteroids to Alleviate Reactions to Intravenous Contrast Material. New England Journal of Medicine. 1987;317(14):845-849. doi: 10.1056/nejm198710013171401.
  21. O’Malley R., Cohan R., Ellis J. et al. A Survey on the Use of Premedication Prior to Iodinated and Gadolinium-Based Contrast Material Administration. Journal of the American College of Radiology. 2011;8(5):345-354. DOI: 10.1016/j. jacr.2010.09.001.
  22. Lasser E. Pretreatment with corticosteroids to prevent reactions to i.v. contrast material: overview and implications. American Journal of Roentgenology. 1988; 150(2):257-259. doi: 10.2214/ajr. 150.2.257.
  23. Dunsky E., Zweiman B., Fischler E., Levy D. Early effects of corticosteroids on basophils, leukocyte histamine, and tissue histamine. Journal of Allergy and Clinical Immunology 1979;63(6):426-432. doi: 10.1016/0091-6749(79)90217-3.
  24. Greenberger PA, Patterson R., Tapio CM. Prophylaxis against repeated radiocontrast media reactions in 857 cases. Adverse experience with cimetidine and safety of beta-adrenergic antagonists. Arch Intern Med. 1985;145(12):2197-2200. doi: 10.1001/archinte.145.12.2197.



Abstract - 109

PDF (Russian) - 0


Article Metrics

Metrics Loading ...


Copyright (c) 2019 Russian Allergological Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies