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논문 기본 정보

자료유형
학술저널
저자정보
Grueber Hans-Peter (Radiology Division Spital Region Oberaargau Spital Langenthal Langenthal Switzerland.) Helbling Arthur (Division of Allergology and Clinical Immunology Department of Pneumology Inselspital Bern Universit) Joerg Lukas (Division of Allergology and Clinical Immunology Department of Pneumology Inselspital Bern Universit)
저널정보
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.13 No.6
발행연도
2021.11
수록면
933 - 938 (6page)
DOI
10.4168/aair.2021.13.6.933

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초록· 키워드

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Allergies to gadolinium-based contrast agents (GBCAs) are rare and manifest usually as an immediate drug hypersensitivity reaction (DHR), compatible with an immunoglobulin E (IgE)-mediated mechanism. Although the molecular structures of GBCA show some similarities and are either linear or macrocyclic, the frequency and pattern of cross-reactivity remain unclear. However, cross-reactivity has been described. The aim of this investigation was to assess cross-reactivity in patients with GBCA allergy based on skin tests and exposure. We retrospectively evaluated a total of 28 cases with a proven allergy to a GBCA, including 11 from the database of the allergy division of the Inselspital, Bern and 17 published cases from the literature, retrieved with a PubMed-MEDLINE search. The majority of cases were immediate DHR, with 8/11 cases from the database (72.7%) and 16/17 published cases (94.1%). In both groups macrocyclic GBCA were most often identified as causative drugs. A cross-reactivity based on skin test results was found in 2 out of 11 database cases (18.2%) and in 6 out of 17 literature cases (35.3%). Cross-reactivity occurred within macrocyclic GBCA in 1/11 database cases and 3/17 literature cases, and included both macrocyclic and linear GBCA in 1/11 and 4/17 subjects. There was no cross sensitization among linear GBCA. Skin test-negative GBCA were well tolerated, even in cases with sensitization to linear and macrocyclic GBCA. Overall, cross-reactivity in GBCA allergy is rare (approximately 29%), and may occur among macrocyclic GBCA or in between macrocyclic and linear GBCA. IgE to linear GBCA seems to be rarely cross-reactive. Skin test is helpful in identifying safe alternatives, as no reaction to skin test-negative GBCA was observed.
#Gadolinium-based contrast agent (GBCA) #allergy #drug hypersensitivity #skin test #cross-reaction #IgE #T-cell #anaphylaxis #contrast media

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참고문헌 (16)

참고문헌 신청
Uhlig J / 2019 / Acute adverse events in cardiac MR imaging with gadolinium-based contrast agents : results from the European Society of Cardiovascular Radiology(ESCR)MRCT registry in 72, 839 patients / Eur Radiol 29:3686~3695 google schola Fok JS / 2017 / Hypersensitivity reactions to gadolinium-based contrast agents / Curr Opin Allergy Clin Immunol 17:241~246 google schola Kun T / 2012 / Influence of MRI contrast media on histamine release from mast cells / Pol J Radiol 77:19~24 google schola Nagai H / 2017 / A delayed reaction to the magnetic resonance imaging contrast agent gadobutrol / J Allergy Clin Immunol Pract 5:850~851 google schola Tomás M / 2012 / Skin reactions to gadolinium-based contrast media / J Investig Allergol Clin Immunol 22:292~293 google schola

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