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Practice Parameters for Diagnosing and Managing Iodinated Contrast Media Hypersensitivity
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  • María José Torres,
  • Axel Trautmann,
  • Ingrid Böhm,
  • Kathrin Scherer Hofmeier,
  • Annick BARBAUD,
  • Sevim Bavbek,
  • patrizia Bonadonna,
  • Josefina Cernadas,
  • Anca Chiriac,
  • Francesco Gaeta,
  • Ana Giménez Arnau,
  • Hye-Ryun Kang,
  • Esther Moreno,
  • Knut Brockow
María José Torres
Universidad de Málaga Facultad de Medicina
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Axel Trautmann
University of Würzburg
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Ingrid Böhm
Inselspital, University of Bern
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Kathrin Scherer Hofmeier
University Hospital Basel
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Annick BARBAUD
Sorbonne Universités, UPMC Univ Paris 06
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Sevim Bavbek
Ankara University School of Medicine
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patrizia Bonadonna
Integrated University Hospital of Verona
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Josefina Cernadas
University Hospital S João, Porto , Portugal
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Anca Chiriac
Hôpital Arnaud de Villeneuve, University Hospital of Montpellier
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Francesco Gaeta
Columbus Hospital, Agostino Gemelli IRCCS University Hospital
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Ana Giménez Arnau
Hospital del Mar. Institut Mar d´Investigacions Mediques
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Hye-Ryun Kang
Seoul National University College of Medicine
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Esther Moreno
Allergy Unit, University Hospital of Salamanca, Spain
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Knut Brockow
Technical University of Munich
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Abstract

Immediate and non-immediate hypersensitivity reactions to iodinated contrast media (ICM) have been reported to occur in a frequency of about 0.5-3% of patients receiving non-ionic ICM. The diagnosis and management of these patients is controversial among guidelines published by various national and international scientific societies, with recommendations ranging from avoidance or premedication to drug provocation test. This position paper aims to give recommendations for the management of patients with ICM hypersensitivity reactions and analyze controversies in this area. Skin tests are recommended as the initial step for diagnosing patients with immediate and non-immediate hypersensitivity reactions; besides, they may also help guide on tolerability of alternatives. Drug provocation test is the gold-standard; although, as it is a risky procedure, the decision for performing it needs to be taken based on a risk-benefit analysis. Another source of controversy is the role of in vitro tests for diagnosis and pretreatment for preventing reactions.

Peer review status:IN REVISION

21 Jul 2020Submitted to Allergy
22 Jul 2020Submission Checks Completed
22 Jul 2020Assigned to Editor
23 Jul 2020Reviewer(s) Assigned
09 Aug 2020Review(s) Completed, Editorial Evaluation Pending
10 Aug 2020Editorial Decision: Revise Minor
15 Sep 20201st Revision Received
15 Sep 2020Submission Checks Completed
15 Sep 2020Assigned to Editor
17 Sep 2020Reviewer(s) Assigned
20 Sep 2020Review(s) Completed, Editorial Evaluation Pending
21 Sep 2020Editorial Decision: Revise Minor