J Korean Soc Clin Pharmacol Ther.  2012 Dec;20(2):165-174.

Retrospective Analysis of Adverse Reactions to Iodinated Contrast Media in Korean

Affiliations
  • 1Department of Pharmacology, Inje University College of Medicine, Korea. phshinjg@inje.ac.kr
  • 2Department of Biomedical Sciences, Seoul National University College of Medicine, Korea.
  • 3Department of Clinical Pharmacology, Inje University Busanpaik Hospital, Korea.
  • 4Department of Radiology, Inje University Busanpaik Hospital, Korea.

Abstract

BACKGROUND
This study was performed to evaluate the prevalence and risk factors on the adverse reactions caused by iodinated contrast media (CM) for computed tomography (CT) examination in a university hospital.
METHODS
Clinical and demographic data among outpatients with CM use were collected at 0000 University Busanpaik Hospital in Busan, Korea between 2008 and 2010. Adverse reaction rate was calculated by the number of adverse reaction among total outpatients with CM use, which was stratified by seasons and sex. The association of risk factors on adverse reaction was investigated using logistic regression model.
RESULTS
The total outpatients and events of administered CMs were 27,587 and 48,616, respectively. The administered CMs were iopromide, iohexol, iobitridol, and iodixanol. Adverse reactions occurred in 300 outpatients among the total outpatients (1.1 %). The number of outpatients administered CM more than twice were 8,348. Among them, outpatients who experienced adverse reaction(s) more than once and twice were 124 (1.5 %) and 26 (0.3 %), respectively. Adverse reaction rate was significantly different by sex(p=0.01). The other risk factors were cancer history (OR 2.57, 95 % CI 2.00-3.31) and previous CM administration (OR 1.89, 95 % CI 1.47-2.44). Urticaria was the most frequent symptoms.
CONCLUSION
Total adverse reaction rate was 1.1 % with most common symptom in skin system. Related risk factors were female, cancer history, and previous CM administration. These results were similar to previous studies and will be contribute to clinical practice and future research especially in Koreans.

Keyword

Adverse reactions; Contrast media; Retrospective studies; Risk factors

MeSH Terms

Contrast Media
Female
Humans
Iohexol
Korea
Logistic Models
Outpatients
Prevalence
Retrospective Studies
Risk Factors
Seasons
Skin
Triiodobenzoic Acids
Urticaria
Contrast Media
Iohexol
Triiodobenzoic Acids

Figure

  • Figure 1 Comparison of age distribution in patients with and without adverse reactions. *Patients without adverse reactions; †Patients with adverse reactions.


Reference

1. Thomson K, Varma D. Safe use of radiographic contrast media. last visited on 22 Oct 2012. Australian Prescriber. http://www.australianprescriber.com/magazine/33/1/19/22/. [Online].
2. Eloy R, Corot C, Belleville J. Contrast media for angiography: physicochemical properties. pharmacokinetics and biocompatibility. Clin Mater. 1991. 7(2):89–197.
Article
3. Dillman JR, Ellis JH, Cohan RH, Strouse PJ, Jan SC. Frequency and severity of acute allergic-like reactions to gadolinium-containing i.v. contrast media in children and adults. AJR Am J Roentgenol. 2007. 189(6):1533–1538.
Article
4. 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.
Article
5. Christiansen C. Late-onset allergy-like reactions to X-ray contrast media. Curr Opin Allergy Clin Immunol. 2002. 2(4):333–339.
Article
6. Lieberman PL, Seigle RL. Reactions to radiocontrast material. Anaphylactoid events in radiology. Clin Rev Allergy Immunol. 1999. 17(4):469–496.
7. 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.
Article
8. Caro JJ, Trindade E, McGregor M. The risks of death and of severe nonfatal reactions with high- vs low-osmolality contrast media: a meta-analysis. AJR Am J Roentgenol. 1991. 156(4):825–832.
Article
9. Idee JM, Pines E, Prigent P, Corot C. Allergy-like reactions to iodinated contrast agents. A critical analysis. Fundam Clin Pharmacol. 2005. 19(3):263–281.
Article
10. Lang DM, Alpern MB, Visintainer PF, Smith ST. Gender risk for anaphylactoid reaction to radiographic contrast media. J Allergy Clin Immunol. 1995. 95(4):813–817.
Article
11. Singh J, Daftary A. Iodinated contrast media and their adverse reactions. J Nucl Med Technol. 2008. 36(2):69–74.
Article
12. Shulman KL, Thompson JA, Benyunes MC, Winter TC, Fefer A. Adverse reactions to intravenous contrast media in patients treated with interleukin-2. J Immunother Emphasis Tumor Immunol. 1993. 13(3):208–212.
Article
13. Kopp AF, Mortele KJ, Cho YD, Palkowitsch P, Bettmann MA, Claussen CD. Prevalence of acute reactions to iopromide: postmarketing surveillance study of 74,717 patients. Acta Radiol. 2008. 49(8):902–911.
Article
14. Petersein J, Peters CR, Wolf M, Hamm B. Results of the safety and efficacy of iobitridol in more than 61,000 patients. Eur Radiol. 2003. 13(8):2006–2011.
Article
15. Kwon KS, Jeong JS. Analysis of Adverse Reactions to Computed Tomography Contrast Medium. J Korean Biol Nurs Sci. 2004. 6(2):57–68. (Korean).
16. Bush WH, Swanson DP. Radiocontrast. Immunol Allergy Clin North Am. 1995. 15:597–612.
17. Slater JE, Kaliner M. Effects of sex hormones on basophil histamine release in recurrent idiopathic anaphylaxis. J Allergy Clin Immunol. 1987. 80(3 Pt 1):285–290.
Article
18. Chernecky C. Documented allergies of patients with cancer. Eur J Cancer Care (Engl). 2003. 12(4):369–371.
Article
19. Zukiwski AA, David CL, Coan J, Wallace S, Gutterman JU, Mavligit GM. Increased incidence of hypersensitivity to iodine-containing radiographic contrast media after interleukin-2 administration. Cancer. 1990. 65(7):1521–1524.
Article
20. Munechika H, Hiramatsu Y, Kudo S, Sugimura K, Hamada C, Yamaguchi K, Katayama H. A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography. Eur Radiol. 2003. 13(1):185–194.
Article
21. Brockow K, Romano A, Aberer W, Bircher AJ, Barbaud A, Bonadonna P, Faria E, Kanny G, Lerch M, Pichler WJ, Ring J, Rodrigues Cernadas J, Tomaz E, Demoly P, Christiansen C. Skin testing in patients with hypersensitivity reactions to iodinated contrast media - a European multicenter study. Allergy. 2009. 64(2):234–241.
Article
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