Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Late adverse reactions to iopromide (Ultravist®) diagnosed by the patch test: a case report

첩포검사로 진단된 Iopromide (Ultravist®)의 지연성 부작용 1예

  • Lee, Soon Joo (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Yang, Eun Mi (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Choi, Woo Yeon (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Song, Eun Song (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Han, Dong Kyun (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Cho, Young Kuk (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Ma, Jae Sook (Department of Pediatrics, Chonnam National University Medical School, Chonnam National University Hospital)
  • 이순주 (전남대학교 의과대학 소아과학교실) ;
  • 양은미 (전남대학교 의과대학 소아과학교실) ;
  • 최우연 (전남대학교 의과대학 소아과학교실) ;
  • 송은송 (전남대학교 의과대학 소아과학교실) ;
  • 한동균 (전남대학교 의과대학 소아과학교실) ;
  • 조영국 (전남대학교 의과대학 소아과학교실) ;
  • 마재숙 (전남대학교 의과대학 소아과학교실)
  • Received : 2008.09.02
  • Accepted : 2008.02.13
  • Published : 2009.04.15
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Abstract

Iodinated contrast media (CM) can cause immediate and late reactions. We treated a patient with a recurrent generalized maculopapular rash and a fever that occurred within two days of exposure to iodinated CM, iopromide ($Ultravist^{(R)}$), for chest computed tomography. We performed skin testing including prick tests, intradermal tests, and patch tests. Our findings indicated a late skin reaction to $Ultravist^{(R)}$in addition to cross-reactions to other iodinated CM such as ioversol ($Optiray^{(R)}$), iohexol ($Iobrix^{(R)}$), and iobitridol ($Xenetix^{(R)}$). In this study, we report the case of a patient diagnosed with a late adverse reaction to $Ultravist^{(R)}$in addition to cross-reactions to other iodinated CM.

요오드성 조영제는 즉각적인 부작용과 지연성 부작용을 일으킬 수 있다. 저자들은 컴퓨터 단층 촬영을 위해 요오드성 조영제인 iopromide ($Ultravist^{(R)}$)를 사용하고 2일 뒤에 전신에 반점 구진성 반점과 발열이 반복적으로 발생한 환아를 경험하였다. 이 환아에서 피부단자시험, 피내반응검사, 첩포검사를 포함한 피부반응검사를 시행하여 $Ultravist^{(R)}$에 지연성 반응임을 확인하고 다른 조영제인 ioversol ($Optiray^{(R)}$), iohexol ($Iobrix^{(R)}$), iobitridol ($Xenetix^{(R)}$) 에도 교차반응이 있음을 확인하였기에 보고하는 바이다.

Keywords

References

  1. Christiansen C, Pichler WJ, Skotland T. Delayed allergy- like reactions to X-ray contrast media: mechanistic considerations. Eur Radiol 2000;10:1965-75 https://doi.org/10.1007/s003300000543
  2. Delgado-Jimenez Y, Perez-Gala S, Arag$\ddot{u}$\acute{e}s M, Sanchez- Perez J, Garcia-Diez A. Late skin reaction to iodixanol (Visipaque): clinical manifestations, patch test study, and histopathological evaluation. Contact Dermatitis 2006;55:348-5 https://doi.org/10.1111/j.1600-0536.2006.00957.x
  3. Calnan CD, Fregert S, Magnusson B. The International Contact Dermatitis Research Group. Cutis. 1976;18:708-10
  4. Panto PN, Davies P. Delayed reactions to urographic contrast media. Br J Radiol 1986;59:41-4 https://doi.org/10.1259/0007-1285-59-697-41
  5. Webb JA, Stacul F, Thomsen HS, Morcos SK. Late adverse reactions to intravascular iodinated contrast media. Eur Radiol 2003;13:181-4 https://doi.org/10.1007/s00330-003-1874-z
  6. Vernassiere C, Trechot P, Comu´n N, Schmutz JL, Barbaud A. Low negative predictive value of skin tests in investigating late reactions to radio-contrast media. Contact Dermatitis 2004;50:359-66 https://doi.org/10.1111/j.0105-1873.2004.00367.x
  7. Brockow K, Christiansen C, Kanny G, Clément O, Barbaud A, Bircher A, et al. Management of hypersensitivity reactions to iodinated contrast media. Allergy 2005;60:150-8 https://doi.org/10.1111/j.1398-9995.2005.00745.x
  8. Barbaud A, Goncalo M, Bruynzeel D, Bircher A. Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. Contact Dermatitis 2001; 45:321-8 https://doi.org/10.1034/j.1600-0536.2001.450601.x
  9. Barbaud A, Reichert-Penetrat S, Trechot P, Jacquin-Petit MA, Ehlinger A, Noirez V, et al. The use of skin testing in the investigation of cutaneous adverse drug reactions. Br J Dermatol 1998;139:49-58 https://doi.org/10.1046/j.1365-2133.1998.02313.x
  10. Schick E, Weber L, Gall H. Delayed hypersensitivity reaction to the non-ionic contrast medium iopromid. Contact Dermatitis 1996;35:312 https://doi.org/10.1111/j.1600-0536.1996.tb02403.x
  11. Kanny G, Marie B, Hoen B, Trechot P, Moneret-Vautrin DA. Delayed adverse reaction to sodium ioxaglic acid- meglumine. Eur J Dermatol 2001;11:134-7
  12. Idee J M, Pines EM, Prigent P, Corot C. Allergy-like reactions to iodinated contrast agents. A critical analysis. Fund Clin Pharmacol 2005;19:263-81 https://doi.org/10.1111/j.1472-8206.2005.00326.x
  13. Mikkonen R, Vehmas T, Granlund H, Kivisaari L. Seasonal variation in the occurrence of late adverse skin reactions to iodine-based contrast media. Acta Radiol 2000;41:3 https://doi.org/10.3109/00016925409174458
  14. Hosoya T, Yamaguchi K, Akutzu T, Mitsuhashi Y, Kondo S, Sugai Y, et al. Delayed adverse reactions to iodinated contrast media and their risk factors. Radiat Med 2000; 18: 39-45
  15. Romano A, Artesani MC, Andriolo M, Viola M, Pettinato R, Vecchioli-Scaldazza A. Effective prophylactic protocol in delayed hypersensitivity to contrast media: report of a case involving lymphocyte transformation studies with different compounds. Radiology 2002;225:466-70 https://doi.org/10.1148/radiol.2251011654