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Varied incidence of immediate adverse reactions to low-osmolar non-ionic iodide radiocontrast media used in computed tomography

 S. R. Kim  ;  J. H. Lee  ;  K. H. Park  ;  H. J. Park  ;  J. W. Park 
 Clinical and Experimental Allergy, Vol.47(1) : 106-112, 2017 
Journal Title
 Clinical and Experimental Allergy 
Issue Date
Adolescent ; Adult ; Aged ; Anaphylaxis ; Case-Control Studies ; Child ; Child, Preschool ; Contrast Media/adverse effects* ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/epidemiology* ; Drug Hypersensitivity/etiology* ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Iodides/adverse effects* ; Male ; Middle Aged ; Odds Ratio ; Risk ; Tomography, X-Ray Computed/adverse effects* ; Young Adult
anaphylaxis ; immediate adverse drug reaction ; non-ionic radiocontrast media
BACKGROUND: Low-osmolar non-ionic radiocontrast media (RCMs) are commonly used throughout hospitals. However, the incidence of immediate adverse drug reactions (ADRs) to various low-osmolar non-ionic RCMs is not well studied. We compared the incidence of immediate ADRs among different low-osmolar non-ionic RCMs used in computed tomography (CT). METHODS: Severance Hospital has collected data for adverse reactions occurring in-hospital using an internally developed system. Using this data, we reviewed 1969 immediate ADRs from 286 087 RCM-contrasted CT examinations of 142 099 patients and compared the immediate ADRs of iobitridol, iohexol, iopamidol, and iopromide. We analysed the incidence of immediate ADRs to different RCMs, as well as the effect of single or multiple CT examinations per day. RESULTS: Iopromide showed the highest incidence of immediate ADRs (1.03%) and was followed by iopamidol (0.67%), iohexol (0.64%), and iobitridol (0.34%). In cases of anaphylaxis, iopromide also showed the highest incidence (0.041%), followed by iopamidol (0.023%), iohexol (0.018%), and iobitridol (0.012%). Risk of immediate ADR due to multiple CT examinations (1.19%) was significantly higher than the risk due to a single CT examination (0.63%). Risk of anaphylaxis was also higher for multiple CT examinations (0.052%) than for a single CT examination (0.020%). CONCLUSIONS AND CLINICAL RELEVANCE: The incidence of immediate ADRs varied according to the low-osmolar non-ionic RCM used. Iopromide-induced immediate ADRs were more frequent, while iobitridol was associated with fewer immediate ADRs than other RCMs. Multiple CT examinations per day resulted in a higher incidence of immediate ADRs and anaphylaxis than a single CT examination. Clinicians should consider these risk differences of immediate ADRs when prescribing contrasted CT examinations.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김성렬(Kim, Sung Ryeol) ORCID logo https://orcid.org/0000-0001-7418-0049
박경희(Park, Kyung Hee) ORCID logo https://orcid.org/0000-0003-3605-5364
박중원(Park, Jung Won) ORCID logo https://orcid.org/0000-0003-0249-8749
박혜정(Park, Hye Jung) ORCID logo https://orcid.org/0000-0002-1862-1003
이재현(Lee, Jae Hyun) ORCID logo https://orcid.org/0000-0002-0760-0071
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