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lunes, 19 de septiembre de 2016

Radiocontrast, Iodine, and Seafood Allergies

R.E.B.E.L. EM - Emergency Medicine Blog
R.E.B.E.L.EM - February 4, 2014 - By Salim Rezaie
"Computed Tomography (CT) scan using radiocontrast is one of the most common imaging modalities used in emergency departments today. Several studies and my own anecdotal experiences indicate that both physicians and patients believe that iodine allergies are linked to seafood allergies and that both are related to a disproportionate increased risk of “allergic” reactions to radiocontrast agents. To add further insult to injury, some hospitals have premedication protocols with steroids and antihistamines requiring up to 12 hours before CT scans with intravenous contrast can be performed. So what is the relationship of radiocontrast, iodine, and seafood allergies?
Relationship of Radiocontrast, Iodine, and Seafood Allergies
Take Home Points:
  • Seafood allergy confers the same risk of radiocontrast reaction as:
    • ANY allergies (not just seafood allergies)
    • Having a previous reaction to a contrast agent
    • Evidence of atopy (i.e. asthma)
  • Iodine is NOT an allergen!!!
  • Low-Osmolar Contrast Media (LOCM) has significantly reduced the number of severe reactions to radiocontrast
  • Premedication with steroids has not been shown to decrease the number of severe allergic reactions to radiocontrast