지연형 조영제 과민반응의 임상 양상 (Clinical features of delayed contrast media hypersensitivity)

서지정보

· 발행기관 : 대한 소아알레르기 호흡기학회
· 수록지 정보 : Allergy Asthma & Respiratory Disease / 2권 / 5호 / 352 ~ 357페이지
· 저자명 : 김민혜, 이서영, 이승은, 김미영, 조은정, 박창민, 이활, 조상헌, 강혜련

초록

Purpose: Delayed hypersensitivity reaction can occur in a couple of hours to several days after injection of iodine-based contrast media (ICM). ICM-related delayed type hypersensitivity is not common but increasing as rapid growth of ICM use. Nevertheless, objective data on delayed type hypersensitivity are still scarce worldwide including Korea. This study was performed to investigate the clinical features of ICM-induced delayed hypersensitivity in Korean patients.
Methods: We retrospectively reviewed the electronic medical records of patients diagnosed with delayed hypersensitivity to ICM from January 2009 to December 2012 at Seoul National University Hospital and analyzed the data to identify the clinical characteristics of these patients.
Results: A total of 44 cases were diagnosed as delayed-type hypersensitivity to ICM. The mean age was 54 years, and 70.5% were female. The mean number of previous ICM exposure was 3.8, and skin reactions were the most common symptoms. In 45% of patients, hypersensitivity reaction developed on the first exposure to ICM. Among the 27 patients exposed to ICM again, hypersensitivity reactions recurred in only 4 patients (14.8%). There was no difference of recurrence rate according to the use of premedication or the change in ICM.
Conclusion: In this study, we observed a female predominance and a low recurrence rate in delayed hypersensitivity to ICM. Premedication and ICM change was not effective in preventing recurrence of delayed type reactions.

영어초록

Purpose: Delayed hypersensitivity reaction can occur in a couple of hours to several days after injection of iodine-based contrast media (ICM). ICM-related delayed type hypersensitivity is not common but increasing as rapid growth of ICM use. Nevertheless, objective data on delayed type hypersensitivity are still scarce worldwide including Korea. This study was performed to investigate the clinical features of ICM-induced delayed hypersensitivity in Korean patients.
Methods: We retrospectively reviewed the electronic medical records of patients diagnosed with delayed hypersensitivity to ICM from January 2009 to December 2012 at Seoul National University Hospital and analyzed the data to identify the clinical characteristics of these patients.
Results: A total of 44 cases were diagnosed as delayed-type hypersensitivity to ICM. The mean age was 54 years, and 70.5% were female. The mean number of previous ICM exposure was 3.8, and skin reactions were the most common symptoms. In 45% of patients, hypersensitivity reaction developed on the first exposure to ICM. Among the 27 patients exposed to ICM again, hypersensitivity reactions recurred in only 4 patients (14.8%). There was no difference of recurrence rate according to the use of premedication or the change in ICM.
Conclusion: In this study, we observed a female predominance and a low recurrence rate in delayed hypersensitivity to ICM. Premedication and ICM change was not effective in preventing recurrence of delayed type reactions.

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