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خرید پکیج

تعداد آیتم قابل مشاهده باقیمانده : 3 مورد

Immediate reactions to iodinated contrast agents: Physiologic (toxic) versus hypersensitivity (allergy-like)

Immediate reactions to iodinated contrast agents: Physiologic (toxic) versus hypersensitivity (allergy-like)

	Physiologic	Hypersensitivity
Type of reaction (and other terminology used)	Physiologic Also called: toxic, chemotoxic.	Hypersensitivity Also called: allergy-like, allergic-like.
Timing relative to administration	Within minutes to one hour by definition. Often within seconds.	Within minutes to one hour by definition.
Signs and symptoms	Transient warmth or chills Localized injection site reactions (eg, erythema) Pruritus only Nausea or vomiting Hypertension Chest pain Sneezing, rhinorrhea, conjunctival injection Seizure Vasovagal reaction (ie, hypotension and bradycardia) Pulmonary edema Arrhythmia	Urticaria or angioedema Widespread erythema Hoarseness or stridor, with or without hypoxia (ie, upper airway compromise) Repetitive cough, wheezing, or chest tightness, with or without hypoxia (ie, lower airway compromise) Anaphylactic shock (ie, hypotension and tachycardia)
Predictability	Infusion rate-dependent Most common with angiography	Infusion rate-independent Idiosyncratic and unpredictable Reactions with initial exposures are usually idiosyncratic and unpredictable IgE-mediated reactions more likely if patient had previous recent exposure to similar RCM
Possible pathophysiology	Possibly related to direct chemotoxicity, osmotoxicity, or binding of agent to endogenous molecules.	Mechanism of mild reactions is unclear; direct mast cell activation has been proposed. Some reactions in re-exposed patients may be IgE mediated.
Severity	Most are mild and self-limited.	Most are mild and self-limited but severe reactions can be fatal.
Risk factors	High dose and osmolarity, angiography.	Previous immediate hypersensitivity reaction.
Allergy testing indicated?	No.	Yes, especially for moderate to severe reactions. Premedication is usually effective for preventing recurrences of mild reactions.

IgE: immunoglobulin E; RCM: radiocontrast media.

Graphic 121978 Version 2.0

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