PENATALAKSANAAN DAN PENCEGAHAN REAKSI HIPERSENSITIVITAS AKUT AKIBAT MEDIA KONTRAS

Ni Made Nova Andari Kluniari; I Ketut Suardamana

doi:10.23887/gm.v3i1.57851

Authors

Ni Made Nova Andari Kluniari Program Studi Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Udayana
I Ketut Suardamana

DOI:

https://doi.org/10.23887/gm.v3i1.57851

Keywords:

contrast, hypersensitivity reaction, steroid, antihistamin

Abstract

The used of iodinated contrast media have increased in recent years. It has been estimated that in the United States alone, 15 million procedures a year contrast media. Approximately 2-3 % patient do pyelogram and myelogram retrograde occurred anaphylactoid reaction. The reaction event during procedure using iodinated contrast media could be fatal. The activated mast cell was not mediated by IgE. Although the use of Low Osmolarity iodinated contrast media could lower the risk of allergic reaction, it was still possible to occur anaphylactoid reaction during the procedure. Here we reported allergic event after using contrast media during PCI procedure. The symptom was relieved with steroid and antihistamin therapy. In this report we focus to discuss the management of preventing allergic reaction and the therapy if the allergic reaction occur.

References

Cochran ST. Anaphylactoid reactions to radiocontrast media. Cure Allergy Asthma Rep 2005;5:28e31.

Morzycki A, Bhatia A, Murphy KJ, dkk. Adverse Reactions to Contrast Material: A Canadian Update. Can Assoc of Radiol J 2017; 68:187-93

Kopp AF, Mortele KJ, Cho YD, Palkowitsch P, Bettmann MA dan Claussen CD. Prevalence of acute reactions to iopromide: postmarketing surveillance study of 74,717 patients. Acta Radiol 2008; 49: 902–11.

Christiansen C. X-ray contrast media – an overview. Toxicology 2005; 209: 185–7.

Kvedarine V, Martins P, Rouanet L dan Demoly P. Diagnosis of iodinated contrast media hypersensitivity: results of a 6-year period. Clin Exp Allergy 2006; 36: 1072–7.

Brockow K, Christiansen C, Kanny G, Clément O, Barbaud A, Bircher A, dkk. Management of hypersensitivity reactions to iodinated contrast media. Allergy 2005;60:150–8.

Kim S, Jo E, Kim M, dkk. Clinical value of radiocontrast media skin tests as a prescreening and diagnostic tool in hypersensitivity reactions. Ann Allergy Asthma Immunol 2013;110:258e62.

Dawson P. Repeat survey of current practice regarding corticosteroid prophylaxis for patients at risk of adverse reaction to intravascular contrast agents. Clin Radiol 2005, 60:56-7.

Goksel O, Aydın O, Atasoy C, dkk. Hypersensitivity Reactions to Contrast Media: Prevalence, Risk Factors and the Role of Skin Tests in Diagnosis – A Cross-Sectional Survey. Int Arch Allergy Immunol 2011;155:297–305.

Schrijvers R, Demoly P, Chiriac AM. Premedication for Iodinated Contrast Media Induced Immediate Hypersensitivity Reactions. Anaphylaxis 2019.

Delaney A, Carter A dan Fisher M, The prevention of anaphylactoid reactions to iodinated radiological contrast media: a systematic review. BMC Medical Imaging 2006; 6(2)

Lasser EC, Berry CC, Mishkin MM, Williamson B, Zheutlin N dan Silverman JM. Pretreatment with corticosteroids to prevent adverse reactions to nonionic contrast media. AJR Am J Roentgenol 1994, 162(3):523-6