Current Treatment Options in Allergy

, Volume 5, Issue 1, pp 103–117 | Cite as

Hypersensitivity Reactions to Iodinated Contrast Media: Is it a True Allergy?

  • Esther Moreno
  • M. Teresa Gracia-Bara
  • Cristobalina Mayorga
  • Milagros Lázaro
  • M. Valle Campanón
  • Ignacio Dávila
Drug Allergy (MJ Torres Jaén, Section Editor)

Opinion statement

Classically, hypersensitivity reactions to iodinated contrast media (ICM) have been termed pseudoallergic, allergy-like, or anaphylactoid. The origin of these terms to define ICM hypersensitivity reactions could be in relation to the use of traditional, classic, ionic ICMs. These ionic ICMs have a high osmolality, and the reactions have been considered as secondary to non-specific histamine release. Currently, ionic ICMs have been replaced by non-ionic compounds with low or iso-osmolality, which, although to a lesser extent, can also produce hypersensitivity reactions. In recent years, there has been growing evidence that some of these reactions, especially the more severe, can be triggered by an IgE-dependent mechanism. Also, in recent decades, there has been an increase in non-immediate reactions, especially in the form of maculopapular exanthems occurring up to several days after the administration of ICM. In these non-immediate reactions, the involvement of T lymphocytes has been clearly demonstrated. The finding of positive skin tests and other in vitro studies for ICMs would support a specific immunological mechanism in a percentage of ICM-induced reactions. However, although there is a body of evidence suggesting that ICMs can induce true allergy reactions, the main guidelines for contrast media management, such as those proposed by US (American College of Radiology Manual on Contrast Media) or European (European Society of Urogenital Radiology Guidelines on Contrast Media) societies, continue to consider only immediate reactions and handle them as non-allergic reactions, without any allergy testing. In ICM reactions an allergic evaluation should be mandatory, not only to study the possible mechanisms involved but also to identify the ICM involved in the reaction and to find an alternative one that could be used in future radiological explorations.


Hypersensitivity Iodinated contrast media Skin tests Drug provocation tests Basophil activation tests 


Funding Information

The present study has been supported by the Institute of Health “Carlos III” of the Ministry of Economy and Competitiveness (grants cofunded by European Regional Development Fund (ERDF): RETICs ARADyAL (RD16/0006/0001; RD16/0006/0033; RD16/0006/0019).

Compliance with Ethical Standards

Conflict of Interest

Esther Moreno declares that she has no conflict of interest. M. Teresa Gracia-Bara declares the she has no conflict of interest. Cristobalina Mayorga declares the she has no conflict of interest. Milagros Lázaro declares the she has no conflict of interest. M. Valle Campanón declares the she has no conflict of interest. Ignacio Dávila declares the he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Ring J, Arroyave CM, Frizler MJ, Tan EM. In vitro histamine and serotonin release by radiographic contrast media (RCM). Complement-dependent and -independent release reaction and changes in ultrastructure of human blood cells. Clin Exp Immunol. 1978;32:105–18.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Stellato C, de Crescenzo G, Patella V, Mastronardi P, Mazzarella B, Marone G. Human basophil/mast cell releasability. XI. Heterogeneity of the effects of contrast media on mediator release. J Allergy Clin Immunol. 1996;97:838–50.CrossRefPubMedGoogle Scholar
  3. 3.
    Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, et al. Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol. 2004;113:832–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Demoly P, Adkinson NF, Brockow K, Castells M, Chiriac AM, Greenberger PA, et al. International consensus on drug allergy. Allergy. 2014;69:420–37.CrossRefPubMedGoogle Scholar
  5. 5.
    Wolf GL, Arenson RL, Cross AP. A prospective trial of ionic vs nonionic contrast agents in routine clinical practice: comparison of adverse effects. AJR Am J Roentgenol. 1989;152:939–44.CrossRefPubMedGoogle Scholar
  6. 6.
    Laroche D, Aimone-Gastin I, Dubois F, Huet H, Gerard P, Vergnaud MC, et al. Mechanisms of severe, immediate reactions to iodinated contrast material. Radiology. 1998;209:183–90.CrossRefPubMedGoogle Scholar
  7. 7.
    • Brockow K. Immediate and delayed reactions to radiocontrast media: is there an allergic mechanism? Immunol Allergy Clin North Am. 2009;29:453–68. Clear review of hypersensitivity reactions to iodinated contrast mediaCrossRefPubMedGoogle Scholar
  8. 8.
    Trcka J, Schmidt C, Seitz CS, Brocker EB, Gross GE, Trautmann A. Anaphylaxis to iodinated contrast material: nonallergic hypersensitivity or IgE-mediated allergy? AJR Am J Roentgenol. 2008;190:666–70.CrossRefPubMedGoogle Scholar
  9. 9.
    Dewachter P, Laroche D, Mouton-Faivre C, Bloch-Morot E, Cercueil JP, Metge L, et al. Immediate reactions following iodinated contrast media injection: a study of 38 cases. Eur J Radiol. 2011;77:495–501.CrossRefPubMedGoogle Scholar
  10. 10.
    Morales-Cabeza C, Roa-Medellin D, Torrado I, De Barrio M, Fernandez-Alvarez C, Montes-Acenero JF, et al. Immediate reactions to iodinated contrast media. Ann Allergy Asthma Immunol. 2017;119:553–57.CrossRefPubMedGoogle Scholar
  11. 11.
    • Yoon SH, Lee SY, Kang HR, Kim JY, Hahn S, Park CM, et al. Skin tests in patients with hypersensitivity reaction to iodinated contrast media: a meta-analysis. Allergy. 2015;70:625–37. A meta-analysis that evalued skin tests in immediate and non-immediate reactions.CrossRefPubMedGoogle Scholar
  12. 12.
    Dona I, Barrionuevo E, Blanca-Lopez N, Torres MJ, Fernandez TD, Mayorga C, et al. Trends in hypersensitivity drug reactions: more drugs, more response patterns, more heterogeneity. J Investig Allergol Clin Immunol. 2014;24:143–53.PubMedGoogle Scholar
  13. 13.
    •• Rosado Ingelmo A, Dona Diaz I, Cabanas Moreno R, Moya Quesada MC, Garcia-Aviles C, Garcia Nunez I, et al. Clinical practice guidelines for diagnosis and management of hypersensitivity reactions to contrast media. J Investig Allergol Clin Immunol. 2016;26:144–55. Spanish guidelines providing indications for management of hypersensitivity reactions to contrast media.CrossRefPubMedGoogle Scholar
  14. 14.
    Torres MJ, Mayorga C, Cornejo-Garcia JA, Lopez S, Chaves P, Rondon C, et al. Monitoring non-immediate allergic reactions to iodine contrast media. Clin Exp Immunol. 2008;152:233–8.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Kanny G, Pichler W, Morisset M, Franck P, Marie B, Kohler C, et al. T cell-mediated reactions to iodinated contrast media: evaluation by skin and lymphocyte activation tests. J Allergy Clin Immunol. 2005;115:179–85.CrossRefPubMedGoogle Scholar
  16. 16.
    Vernassiere C, Trechot P, Commun N, Schmutz JL, Barbaud A. Low negative predictive value of skin tests in investigating delayed reactions to radio-contrast media. Contact Dermatitis. 2004;50:359–66.CrossRefPubMedGoogle Scholar
  17. 17.
    • Torres MJ, Gomez F, Dona I, Rosado A, Mayorga C, Garcia I, et al. Diagnostic evaluation of patients with nonimmediate cutaneous hypersensitivity reactions to iodinated contrast media. Allergy. 2012;67:929–35. Study showing diagnostic value of skin tests and drug provocation test in non-immedite reactions.CrossRefPubMedGoogle Scholar
  18. 18.
    Caimmi S, Benyahia B, Suau D, Bousquet-Rouanet L, Caimmi D, Bousquet PJ, et al. Clinical value of negative skin tests to iodinated contrast media. Clin Exp Allergy. 2010;40:805–10.CrossRefPubMedGoogle Scholar
  19. 19.
    • Brockow K, Romano A, Aberer W, Bircher AJ, Barbaud A, Bonadonna P, et al. Skin testing in patients with hypersensitivity reactions to iodinated contrast media—a European multicenter study. Allergy. 2009;64:234–41. A European study showing diagnostic value in inmediate and non-immediate reactions to iodinated contrast media.CrossRefPubMedGoogle Scholar
  20. 20.
    • Hasdenteufel F, Waton J, Cordebar V, Studer M, Collignon O, Luyasu S, et al. Delayed hypersensitivity reactions caused by iodixanol: an assessment of cross-reactivity in 22 patients. J Allergy Clin Immunol. 2011;128:1356–7. A study that evalue cross-reactivity between iodinated contrast media in non-immediate reactions.CrossRefPubMedGoogle Scholar
  21. 21.
    Stejskal V, Nilsson R, Grepe A. Immunologic basis for adverse reactions to radiographic contrast media. Acta Radiol. 1990;31:605–12.CrossRefPubMedGoogle Scholar
  22. 22.
    Keller M, Lerch M, Britschgi M, Tache V, Gerber BO, Luthi M, et al. Processing-dependent and -independent pathways for recognition of iodinated contrast media by specific human T cells. Clin Exp Allergy. 2010;40:257–68.CrossRefPubMedGoogle Scholar
  23. 23.
    Lerch M, Keller M, Britschgi M, Kanny G, Tache V, Schmid DA, et al. Cross-reactivity patterns of T cells specific for iodinated contrast media. J Allergy Clin Immunol. 2007;119:1529–36.CrossRefPubMedGoogle Scholar
  24. 24.
    Radiology ESoU. ESUR Guidelines on contrast media Available from
  25. 25.
    ACR Manual on Contrast Media Available from: 2017.].
  26. 26.
    Rawlins MD. Mechanisms of adverse drug reactions. In: Davies DMFR, de Glanville H, editors. Davies’s Textbook of Adverse Drug Reactions. Oxford: Oxford University Press; 1991.Google Scholar
  27. 27.
    Katayama H. Adverse reactions to contrast media. What are the risk factors? Invest Radiol. 1990;25(Suppl 1):S16–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Palmer FJ. The RACR survey of intravenous contrast media reactions. Final report. Australas Radiol. 1988;32:426–8.CrossRefPubMedGoogle Scholar
  29. 29.
    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;156:825–32.CrossRefPubMedGoogle Scholar
  30. 30.
    Gomi T, Nagamoto M, Hasegawa M, Katoh A, Sugiyama M, Murata N, et al. Are there any differences in acute adverse reactions among five low-osmolar non-ionic iodinated contrast media? Eur Radiol. 2010;20:1631–5.CrossRefPubMedGoogle Scholar
  31. 31.
    Chen QL, Zhao XY, Wang XM, Lv N, Zhu LL, Xu HM, et al. Retrospective analysis of non-laboratory-based adverse drug reactions induced by intravenous radiocontrast agents in a Joint Commission International-accredited academic medical center hospital in China. Ther Clin Risk Manag. 2017;13:565–73.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Kim TH, Yoon SH, Lee SY, Choi YH, Park CM, Kang HR, et al. Biphasic and protracted anaphylaxis to iodinated contrast media. Eur Radiol. 2017;27.
  33. 33.
    Kim SR, Lee JH, Park KH, Park HJ, Park JW. Varied incidence of immediate adverse reactions to low-osmolar non-ionic iodide radiocontrast media used in computed tomography. Clin Exp Allergy. 2017;47:106–12.CrossRefPubMedGoogle Scholar
  34. 34.
    Gueant-Rodriguez RM, Romano A, Barbaud A, Brockow K, Gueant JL. Hypersensitivity reactions to iodinated contrast media. Curr Pharm Des. 2006;12:3359–72.CrossRefPubMedGoogle Scholar
  35. 35.
    Szebeni J. Hypersensitivity reactions to radiocontrast media: the role of complement activation. Curr Allergy Asthma Rep. 2004;4:25–30.CrossRefPubMedGoogle Scholar
  36. 36.
    • Lerondeau B, Trechot P, Waton J, Poreaux C, Luc A, Schmutz JL, et al. Analysis of cross-reactivity among radiocontrast media in 97 hypersensitivity reactions. J Allergy Clin Immunol. 2016;137:633–5 e4. This large study analyze cross-reactivity and propose three subgroups of iodinated contrast media with cross-reactivity.CrossRefPubMedGoogle Scholar
  37. 37.
    Salas M, Gomez F, Fernandez TD, Dona I, Aranda A, Ariza A, et al. Diagnosis of immediate hypersensitivity reactions to radiocontrast media. Allergy. 2013;68:1203–6.PubMedGoogle Scholar
  38. 38.
    Prieto-Garcia A, Tomas M, Pineda R, Tornero P, Herrero T, Fuentes V, et al. Skin test-positive immediate hypersensitivity reaction to iodinated contrast media: the role of controlled challenge testing. J Investig Allergol Clin Immunol. 2013;23:183–9.PubMedGoogle Scholar
  39. 39.
    Pinnobphun P, Buranapraditkun S, Kampitak T, Hirankarn N, Klaewsongkram J. The diagnostic value of basophil activation test in patients with an immediate hypersensitivity reaction to radiocontrast media. Ann Allergy Asthma Immunol. 2011;106:387–93.CrossRefPubMedGoogle Scholar
  40. 40.
    Chirumbolo S. Basophil activation test (BAT) in the diagnosis of immediate hypersensitivity reactions to radiocontrast media. Allergy. 2013;68:1627–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Mita H, Tadokoro K, Akiyama K. Detection of IgE antibody to a radiocontrast medium. Allergy. 1998;53:1133–40.CrossRefPubMedGoogle Scholar
  42. 42.
    Alam R, Anantharaman R. Use of IABP in contrast media-induced anaphylactic shock: the ultimate lifesaver. BMJ Case Rep 2013; 2013.
  43. 43.
    Palmiere C, Reggiani Bonetti L. Risk factors in fatal cases of anaphylaxis due to contrast media: a forensic evaluation. Int Arch Allergy Immunol. 2014;164:280–8.CrossRefPubMedGoogle Scholar
  44. 44.
    Jansman FG, Kieft H, Harting JW. Fatal anaphylactoid reaction following ioversol administration. Pharm World Sci. 2007;29:584–6.CrossRefPubMedGoogle Scholar
  45. 45.
    Bohm I. Kounis syndrome in a patient with allergy to iodinated contrast media. Int J Cardiol. 2011;151:102–3.CrossRefPubMedGoogle Scholar
  46. 46.
    Park JM, Cho J, Chung SP, Kim MJ. Kounis syndrome captured by coronary angiography computed tomography. Am J Emerg Med. 2010;28:640 e5–8.CrossRefGoogle Scholar
  47. 47.
    Brown SG. Clinical features and severity grading of anaphylaxis. J Allergy Clin Immunol. 2004;114:371–6.CrossRefPubMedGoogle Scholar
  48. 48.
    Ring J, Messmer K. Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet. 1977;1:466–9.CrossRefPubMedGoogle Scholar
  49. 49.
    Epskamp C, Snels DG, Yo GL, Zuetenhorst HJ, Hamberg P. Bullous fixed drug eruption in a patient with metastatic renal cell carcinoma induced by iodinated contrast during pazopanib treatment. Eur J Dermatol. 2016;26:207–8.PubMedGoogle Scholar
  50. 50.
    Cha SH, Kim HS, Lee JY, Kim HO, Park YM. Fixed drug eruption due to iopromide (Ultravist(R)). Ann Dermatol. 2011;23(Suppl 1):S33–5.CrossRefPubMedPubMedCentralGoogle Scholar
  51. 51.
    Belgodere X, Wolkenstein P, Pastor MJ. Acute generalized exanthematous pustulosis induced by iopamidol. Ann Dermatol Venereol. 2004;131:831–2.CrossRefPubMedGoogle Scholar
  52. 52.
    Poliak N, Elias M, Cianferoni A, Treat J. Acute generalized exanthematous pustulosis: the first pediatric case caused by a contrast agent. Ann Allergy Asthma Immunol. 2010;105:242–3.CrossRefPubMedGoogle Scholar
  53. 53.
    Brockow K, Christiansen C, Kanny G, Clement O, Barbaud A, Bircher A, et al. Management of hypersensitivity reactions to iodinated contrast media. Allergy. 2005;60:150–8.CrossRefPubMedGoogle Scholar
  54. 54.
    Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy. 2002;57:45–51.PubMedGoogle Scholar
  55. 55.
    Kvedariene V, Martins P, Rouanet L, Demoly P. Diagnosis of iodinated contrast media hypersensitivity: results of a 6-year period. Clin Exp Allergy. 2006;36:1072–7.CrossRefPubMedGoogle Scholar
  56. 56.
    Gracia Bara MT, Moreno E, Laffond E, Munoz FJ, Macias E, Davila I. Selection of contrast media in patients with delayed reactions should be based on challenge test results. J Allergy Clin Immunol. 2012;130:554–5. author reply 5–6Google Scholar
  57. 57.
    •• Mayorga C, Celik G, Rouzaire P, Whitaker P, Bonadonna P, Rodrigues-Cernadas J, et al. In vitro tests for drug hypersensitivity reactions: an ENDA/EAACI Drug Allergy Interest Group position paper. Allergy. 2016;71:1103–34. A European position paper providing data and recommendations regarding in vitro methods for drug hypersensitivity reactions.CrossRefPubMedGoogle Scholar
  58. 58.
    Ebo DG, Leysen J, Mayorga C, Rozieres A, Knol EF, Terreehorst I. The in vitro diagnosis of drug allergy: status and perspectives. Allergy. 2011;66:1275–86.CrossRefPubMedGoogle Scholar
  59. 59.
    Bohm I, Speck U, Schild HH. Pilot study on basophil activation induced by contrast medium. Fundam Clin Pharmacol. 2011;25:267–76.CrossRefPubMedGoogle Scholar
  60. 60.
    Javaloyes G, Goikoetxea MJ, Sanz ML, Cabrera-Freitag P, Gastaminza G. Basophil activation test in the diagnosis of gadobutrol anaphylaxis. Ann Allergy Asthma Immunol. 2012;108:286–7.CrossRefPubMedGoogle Scholar
  61. 61.
    Philipse E, Sabato V, Bridts C, De Clerck L, Ebo D. Basophil activation in the diagnosis of life-threatening hypersensitivity reaction to iodinated contrast media: a case report. Acta Clin Belg. 2013;68:140–2.CrossRefPubMedGoogle Scholar
  62. 62.
    Mayorga C, Dona I, Perez-Inestrosa E, Fernandez TD, Torres MJ. The value of in vitro tests to diminish drug challenges. Int J Mol Sci 2017; 18.
  63. 63.
    Antunez C, Barbaud A, Gomez E, Audonnet S, Lopez S, Gueant-Rodriguez RM, et al. Recognition of iodixanol by dendritic cells increases the cellular response in delayed allergic reactions to contrast media. Clin Exp Allergy. 2011;41:657–64.CrossRefPubMedGoogle Scholar
  64. 64.
    Nyfeler B, Pichler WJ. The lymphocyte transformation test for the diagnosis of drug allergy: sensitivity and specificity. Clin Exp Allergy. 1997;27:175–81.CrossRefPubMedGoogle Scholar
  65. 65.
    Zawodniak A, Lochmatter P, Yerly D, Kawabata T, Lerch M, Yawalkar N, et al. In vitro detection of cytotoxic T and NK cells in peripheral blood of patients with various drug-induced skin diseases. Allergy. 2010;65:376–84.CrossRefPubMedGoogle Scholar
  66. 66.
    Sese L, Gaouar H, Autegarden JE, Alari A, Amsler E, Vial-Dupuy A, et al. Immediate hypersensitivity to iodinated contrast media: diagnostic accuracy of skin tests and intravenous provocation test with low dose. Clin Exp Allergy. 2016;46:472–8.CrossRefPubMedGoogle Scholar
  67. 67.
    Aberer W, Bircher A, Romano A, Blanca M, Campi P, Fernandez J, et al. Drug provocation testing in the diagnosis of drug hypersensitivity reactions: general considerations. Allergy. 2003:854–63.Google Scholar
  68. 68.
    Della-Torre E, Berti A, Yacoub MR, Guglielmi B, Tombetti E, Sabbadini MG, et al. Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media. Eur Ann Allergy Clin Immunol. 2015;47:77–85.PubMedGoogle Scholar
  69. 69.
    Park HJ, Park JW, Yang MS, Kim MY, Kim SH, Jang GC, et al. Re-exposure to low osmolar iodinated contrast media in patients with prior moderate-to-severe hypersensitivity reactions: a multicentre retrospective cohort study. Eur Radiol. 2017;27:2886–93.CrossRefPubMedGoogle Scholar
  70. 70.
    Abe S, Fukuda H, Tobe K, Ibukuro K. Protective effect against repeat adverse reactions to iodinated contrast medium: premedication vs. changing the contrast medium. Eur Radiol. 2016;26:2148–54.CrossRefPubMedGoogle Scholar
  71. 71.
    Schatz M, Patterson R, O’Rourke J, Nickelsen J, Northup C. The administration of radiographic contrast media to patients with a history of a previous reaction. J Allergy Clin Immunol. 1975;55:358–66.CrossRefPubMedGoogle Scholar
  72. 72.
    Zweiman B, Mishkin MM, Hildreth EA. An approach to the performance of contrast studies in contrast material-reactive persons. Ann Intern Med. 1975;83:159–62.CrossRefPubMedGoogle Scholar
  73. 73.
    Ring J, Rothenberger KH, Clauss W. Prevention of anaphylactoid reactions after radiographic contrast media infusion by combined histamine H1- and H2-receptor antagonists: results of a prospective controlled trial. Int Arch Allergy Appl Immunol. 1985;78:9–14.CrossRefPubMedGoogle Scholar
  74. 74.
    Marshall GD Jr, Lieberman PL. Comparison of three pretreatment protocols to prevent anaphylactoid reactions to radiocontrast media. Ann Allergy. 1991;67:70–4.PubMedGoogle Scholar
  75. 75.
    Greenberger PA, Patterson R, Tapio CM. Prophylaxis against repeated radiocontrast media reactions in 857 cases. Adverse experience with cimetidine and safety of beta-adrenergic antagonists. Arch Intern Med. 1985;145:2197–200.CrossRefPubMedGoogle Scholar
  76. 76.
    Lee SY, Yang MS, Choi YH, Park CM, Park HW, Cho SH, et al. Stratified premedication strategy for the prevention of contrast media hypersensitivity in high-risk patients. Ann Allergy Asthma Immunol. 2017;118:339–44. e1Google Scholar
  77. 77.
    Jung JW, Choi YH, Park CM, Park HW, Cho SH, Kang HR. Outcomes of corticosteroid prophylaxis for hypersensitivity reactions to low osmolar contrast media in high-risk patients. Ann Allergy Asthma Immunol. 2016;117:304–9. e1Google Scholar
  78. 78.
    Kim SH, Lee SH, Lee SM, Kang HR, Park HW, Kim SS, et al. Outcomes of premedication for non-ionic radio-contrast media hypersensitivity reactions in Korea. Eur J Radiol. 2011;80:363–7.CrossRefPubMedGoogle Scholar
  79. 79.
    Freed KS, Leder RA, Alexander C, DeLong DM, Kliewer MA. Breakthrough adverse reactions to low-osmolar contrast media after steroid premedication. AJR Am J Roentgenol. 2001;176:1389–92.CrossRefPubMedGoogle Scholar
  80. 80.
    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.CrossRefPubMedGoogle Scholar
  81. 81.
    Rosado A, Canto G, Veleiro B, Rodriguez J. Toxic epidermal necrolysis after repeated injections of iohexol. AJR Am J Roentgenol. 2001;176:262–3.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Esther Moreno
    • 1
    • 2
    • 3
  • M. Teresa Gracia-Bara
    • 1
    • 2
  • Cristobalina Mayorga
    • 4
    • 5
  • Milagros Lázaro
    • 1
  • M. Valle Campanón
    • 1
  • Ignacio Dávila
    • 1
    • 2
    • 3
  1. 1.Allergy ServiceUniversity Hospital of SalamancaSalamancaSpain
  2. 2.Department of Biomedical and Diagnostics Sciences, Faculty of MedicineUniversity of SalamancaSalamancaSpain
  3. 3.Institute for Biomedical Research of Salamanca (IBSAL)SalamancaSpain
  4. 4.Research LaboratoryIBIMA—Regional University Hospital of Malaga—UMAMálagaSpain
  5. 5.Allergy UnitIBIMA—Regional University Hospital of Malaga—UMAMálagaSpain

Personalised recommendations