HYPERSENSITIVITY REACTIONS TO CONTRAST MEDIA IN CHILDREN
Keywords:Barium Sulfate, Contrast media, Delayed Hypersensitivity, Gadolinium, Immediate Hypersensitivity, Provocation test, Radiocontrast media, Skin tests.
Introduction: Even though diagnostic and therapeutic contrast-enhanced procedures are very frequently performed in clinical practice, the underlying contrast media may be associated with a wide range of hypersensitivity reactions.
Objective: Overview of epidemiology, clinical presentation, diagnosis and prevention of hypersensitivity reactions to contrast media in pediatric population.
Results: There are two major groups of contrast media: radiologic and non-radiologic, and both may cause hypersensitivity reactions. These reactions can be differentiated according to the time interval between contrast administration and the first appearance of symptoms as: immediate (when they occur during the first hour after administration) or non-immediate (when they occur between one hour up to ten days after administration). IgE-mediated and T cell-mediated immunologic mechanisms appear to be involved in these reactions, respectively. Clinical management aims to determine potential culprit and to identify alternative contrast agents via detailed anamnesis, skin tests and even a possible provocation test. In confirmed cases the culprit preparation should be avoided.
Conclusions: A systematic approach to cases of hypersensitivity reaction to contrast media contributes to prevent recurrent reactions and to administrate alternative contrast media more safely.
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