SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media
Abstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, makin...
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-07-01
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| Series: | Clinical and Molecular Allergy |
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| Online Access: | http://link.springer.com/article/10.1186/s12948-020-00128-3 |
| _version_ | 1828765452060327936 |
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| author | Maria Teresa Costantino Laura Romanini Francesco Gaeta Fulvio Stacul Rocco Luigi Valluzzi Matteo Passamonti Patrizia Bonadonna Giovanni Cerri Stefano Pucci Paolo Ricci Eleonora Savi Michele Galluzzo Marina Mauro Emanuele Grassedonio Mona Rita Yacoub Alfonso Reginelli Sergio Testi Erminia Ridolo Eustacchio Nettis Elisabetta Di Leo Oliviero Rossi Paolo Montuschi Cristoforo Incorvaia Antonino Romano |
| author_facet | Maria Teresa Costantino Laura Romanini Francesco Gaeta Fulvio Stacul Rocco Luigi Valluzzi Matteo Passamonti Patrizia Bonadonna Giovanni Cerri Stefano Pucci Paolo Ricci Eleonora Savi Michele Galluzzo Marina Mauro Emanuele Grassedonio Mona Rita Yacoub Alfonso Reginelli Sergio Testi Erminia Ridolo Eustacchio Nettis Elisabetta Di Leo Oliviero Rossi Paolo Montuschi Cristoforo Incorvaia Antonino Romano |
| author_sort | Maria Teresa Costantino |
| collection | DOAJ |
| description | Abstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested. |
| first_indexed | 2024-12-11T06:47:59Z |
| format | Article |
| id | doaj.art-55493c5080114b05902d8c2066ba2227 |
| institution | Directory Open Access Journal |
| issn | 1476-7961 |
| language | English |
| last_indexed | 2024-12-11T06:47:59Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Clinical and Molecular Allergy |
| spelling | doaj.art-55493c5080114b05902d8c2066ba22272022-12-22T01:17:00ZengBMCClinical and Molecular Allergy1476-79612020-07-0118111010.1186/s12948-020-00128-3SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast mediaMaria Teresa Costantino0Laura Romanini1Francesco Gaeta2Fulvio Stacul3Rocco Luigi Valluzzi4Matteo Passamonti5Patrizia Bonadonna6Giovanni Cerri7Stefano Pucci8Paolo Ricci9Eleonora Savi10Michele Galluzzo11Marina Mauro12Emanuele Grassedonio13Mona Rita Yacoub14Alfonso Reginelli15Sergio Testi16Erminia Ridolo17Eustacchio Nettis18Elisabetta Di Leo19Oliviero Rossi20Paolo Montuschi21Cristoforo Incorvaia22Antonino Romano23Allergy Unit, Department of Medicine, ASST MantovaRadiology, Istituti Ospitalieri di Cremona, ASST CremonaAllergy Unit, Columbus Hospital, Fondazione Policlinico Universitario Agostino Gemelli IRCCSDepartment of Radiology, Ospedale Maggiore, Azienda Sanitaria Universitaria Integrata di TriesteAllergy Unit, Bambino Gesù Children’s Hospital, IRCCSDepartment of Radiology-ASST di LodiAllergy Unit, Azienda Ospedaliera Universitaria Integrata of VeronaDepartment of Radiology, ASST Spedali Civili di BresciaAllergy Unit. General Hospital, Civitanova MarcheDepartment of Radiology, Oncologiche ad Anatomopatologiche, Azienda Policlinico Umberto I, Sapienza Università di RomaDepartmental Unit of Allergology, Guglielmo da Saliceto HospitalDepartment of Radiology, Azienda Ospedaliera San Camillo Forlanini, Ospedale San CamilloAllergy Unit, S. Anna HospitalDepartment of Radiology, Dipartimento di Biopatologia e Biotecnologie Mediche, Policlinico Paolo Giaccone, Università degli Studi di PalermoAllergy and Immunology Department, IRCCS San Raffaele HospitalDepartment of Radiology & Radiotherapy, University of Campania ‘Luigi Vanvitelli’Allergy and Clinical Immunology Unit, San Giovanni di Dio’s HospitalDepartment of Medicine and Surgery Clinical, University of ParmaDepartment of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo MoroSection of Allergy and Clinical Immunology, Unit of Internal Medicine, “F. Miulli” HospitalAllergy Unit, Azienda Ospedaliero Universitaria CareggiPharmacology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCSCardiac/Pulmonary Rehabilitation, ASST Pini-CTOIRCCS Oasi Maria S.S., Troina & Fondazione Mediterranea G.B. MorgagniAbstract Hypersensitivity reactions (HRs) to contrast media (CM) can be distinguished in immune-mediated (including allergic reactions) and non-immune-mediated reactions, even if clinical manifestations could be similar. Such manifestations range from mild skin eruptions to severe anaphylaxis, making it important for radiologists to know how to identify and manage them. A panel of experts from the Società Italiana di Radiologia Medica e Interventistica (SIRM) and the Società Italiana di Allergologia, Asma e Immunologia Clinica (SIAAIC) provided a consensus document on the management of patients who must undergo radiological investigations with CM. Consensus topics included: the risk stratification of patients, the identification of the culprit CM and of a safe alternative by an allergy workup, as well as the use of premedication and the correct procedure to safely perform an elective (i.e., scheduled) or urgent examination. The most important recommendations are: (1) in all patients, a thorough medical history must be taken by the prescribing physician and/or the radiologist to identify at-risk patients; (2) in patients with hypersensitivity reactions to CM, the radiologist must consider an alternative, non-contrast imaging study with a comparable diagnostic value, or prescribe a different investigation with another class of CM; (3) if such options are not feasible, the radiologist must address at-risk patients to a reference centre for an allergy evaluation; (4) if timely referral to an allergist is not viable, it is recommended to use a CM other than the responsible one, taking into account cross-reactivity patterns; in the case of patients with histories of severe reactions, the presence of an anesthesiologist is also recommended and a premedication is suggested.http://link.springer.com/article/10.1186/s12948-020-00128-3Radiologic contrast mediaHypersensitivity reactionsLow-osmolar contrast agentsDiagnosisManagement |
| spellingShingle | Maria Teresa Costantino Laura Romanini Francesco Gaeta Fulvio Stacul Rocco Luigi Valluzzi Matteo Passamonti Patrizia Bonadonna Giovanni Cerri Stefano Pucci Paolo Ricci Eleonora Savi Michele Galluzzo Marina Mauro Emanuele Grassedonio Mona Rita Yacoub Alfonso Reginelli Sergio Testi Erminia Ridolo Eustacchio Nettis Elisabetta Di Leo Oliviero Rossi Paolo Montuschi Cristoforo Incorvaia Antonino Romano SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media Clinical and Molecular Allergy Radiologic contrast media Hypersensitivity reactions Low-osmolar contrast agents Diagnosis Management |
| title | SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| title_full | SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| title_fullStr | SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| title_full_unstemmed | SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| title_short | SIRM-SIAAIC consensus, an Italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| title_sort | sirm siaaic consensus an italian document on management of patients at risk of hypersensitivity reactions to contrast media |
| topic | Radiologic contrast media Hypersensitivity reactions Low-osmolar contrast agents Diagnosis Management |
| url | http://link.springer.com/article/10.1186/s12948-020-00128-3 |
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