Review
Allergy
Hye-Ryun Kang, Jiung Jeong, Knut Brockow
Summary: Iodinated contrast media (ICM) can cause drug hypersensitivity reactions (HSRs), and there is currently a lack of standardized strategies for diagnosis and prevention. A history of hypersensitivity to ICM is the main risk factor, and avoiding the culprit agents and taking preventive measures are the main strategies. Skin tests can help identify sensitized ICM, and ICM provocation test can be useful in selected cases.
ALLERGY ASTHMA & IMMUNOLOGY RESEARCH
(2022)
Article
Allergy
Juliette Caron, Sahara Graf, Christine Delebarre-Sauvage
Summary: Among patients with immediate hypersensitivity reactions to iodinated contrast media, the rate of confirmed allergic patients by positive skin tests was 8.1%. Despite negative skin test results, 12.5% of re-exposed patients experienced recurrent hypersensitivity reactions. Additional investigations on pure intradermal tests to contrast media and development of drug provocation tests could provide a safety net for detecting recurrent reactors. Agreement among allergists is necessary to standardize practices.
CLINICAL AND TRANSLATIONAL ALLERGY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Kyoung-Hee Sohn, Jang-Ho Seo, Dong-Yoon Kang, Suh-Young Lee, Hye-Ryun Kang
Summary: In a cohort of patients with previous immediate hypersensitivity reactions to low-osmolar contrast media, skin testing showed that a significant proportion of patients had positive reactions to at least one LOCM, with many showing cross-reactivity to multiple LOCMs. Reexposure to nonculprit skin test negative LOCM significantly reduced the overall recurrent HSRs, especially in patients with severe index HSRs. Skin test cross-reactivity between LOCMs sharing a common side chain was associated with recurrence of HSRs, and avoiding the common side chain reduced the recurrence rate effectively.
INVESTIGATIVE RADIOLOGY
(2021)
Article
Allergy
Leonardo Bianchi, Katharina Hansel, Filippo Biondi, Elena Sofia Caroppo, Tommaso Galeotti, Gabriele Casciola, Marta Tramontana, Rossella Marietti, Maddalena Napolitano, Cataldo Patruno, Luca Stingeni
Summary: This study aimed to evaluate the usefulness of skin tests in delayed hypersensitivity reactions to iodinated contrast media (ICM) and to assess the tolerability of iobitridol as a safe alternative. The results showed that delayed-type hypersensitivity was demonstrated by skin tests in at least half of the patients, particularly by patch test. This diagnostic approach was simple, cost-effective, and safe, not only for confirming the culprit ICM but also for identifying iobitridol as a feasible alternative.
CONTACT DERMATITIS
(2023)
Review
Biochemistry & Molecular Biology
Tsu-Man Chiu, Sung-Yu Chu
Summary: This review examines the issues related to hypersensitivity reactions to iodinated contrast media, highlighting a history of hypersensitivity as the most significant risk factor. For high-risk populations, a careful evaluation of the benefits and risks of prophylactic medication is necessary. It is recommended to avoid the use of the same iodinated contrast media for patients with a history of severe hypersensitivity.
Article
Allergy
Maria Jose Torres, Axel Trautmann, Ingrid Bohm, Kathrin Scherer, Annick Barbaud, Sevim Bavbek, Patrizia Bonadonna, Josefina Rodrigues Cernadas, Anca Mirela Chiriac, Francesco Gaeta, Ana M. Gimenez-Arnau, Hye-Ryun Kang, Esther Moreno, Knut Brockow
Summary: The management of patients with hypersensitivity reactions to iodinated contrast media involves recommendations such as skin tests, avoidance of re-exposure, or drug provocation tests. The decision to perform re-exposure or drug provocation test should be based on a risk-benefit analysis. The role of in vitro tests for diagnosis and pretreatment remains controversial in preventing reactions.
Review
Immunology
Rakesh D. Bansie, A. Faiz Karim, Maurits S. van Maaren, Maud A. W. Hermans, Paul L. A. van Daele, Roy Gerth van Wijk, Saskia M. Rombach
Summary: Skin tests and provocation tests are recommended for evaluating hypersensitivity reactions to contrast agents, showing a high risk of immediate repeat hypersensitivity reactions for skin-test-positive patients. However, provocation tests are not common in clinical practice.
INTERNATIONAL JOURNAL OF IMMUNOPATHOLOGY AND PHARMACOLOGY
(2021)
Article
Allergy
Pedro Gamboa, Javier Sanchez de Vicente, Cristina Galan, Ignacio Jauregui, Aritza Segurola, Eduardo Garcia-Lirio, Yolanda Seras, Ma Dolores Martinez-Anton, Angel Arrien de Lecea
Summary: Skin tests had a sensitivity of less than 50% for patients with NIHRs due to iomeprol, while the negative predictive value of skin tests in patients who tolerated challenges with alternative contrasts (mainly iopamidol) was 53%. The cross-reactivity between iomeprol and iopamidol is high.
Review
Medicine, General & Internal
Chen Hsieh, Shan Chia Wu, Russell Oliver Kosik, Yu-Chen Huang, Wing P. Chan
Summary: This meta-analysis provides evidence that premedication with corticosteroids prior to administration of iodinated contrast media can significantly reduce the recurrence of moderate and severe hypersensitivity reactions in high-risk patients.
Article
Medicine, General & Internal
Violeta Kvedariene, Monika Orvydaite, Paulina Petraityte, Justina Rudyte, Algirdas Edvardas Tamosiunas
Summary: The study found that one-third of investigated hypersensitivity reactions to iodinated contrast media were classified as non-immediate type, with most of them manifesting with isolated skin symptoms. The overall confirmation rate for non-immediate hypersensitivity after diagnostic evaluation was only 15%.
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
(2021)
Article
Allergy
Ji-Hyang Lee, Youngsang Yoo, Sung-Ryeol Kim, Jae-Hyun Lee, Seo-Young Kim, Jin An, So-Young Park, Han-ki Park, Sujeong Kim, Woo-Jung Song, Min-suk Yang, Hyouk-Soo Kwon, Hye-Kyung Park, Jaechun Lee, Gyu-Young Hur, Gang-Jee Ko, Sang-Heon Kim, Sae-Hoon Kim, Young-min Ye, Young-Il Koh, Byung-Jae Lee, You Sook Cho, Hwan Seok Yong, Tae-Bum Kim
Summary: This study aimed to propose an intradermal skin test-guided strategy to prevent recurrence of drug-induced immediate hypersensitivity reaction (IHR) to iodinated contrast media (ICM). The study found that following this strategy could reduce the recurrence rate of IHR and mitigate the severity in recurred cases.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2023)
Article
Biochemistry & Molecular Biology
Eleonora Nucera, Giuseppe Parrinello, Sebastiano Gangemi, Alessandro Buonomo, Arianna Aruanno, Franziska Michaela Lohmeyer, Riccardo Inchingolo, Angela Rizzi
Summary: This study compared hypersensitivity reactions to different types of contrast media and explored the possibility of new reactions in a long-term follow-up. It was found that patients with hypersensitivity reactions to gadolinium-based contrast media had a higher prevalence of asthma, food allergy, non-allergic drug hypersensitivity, and neurologic disease. Some patients reported new reactions despite negative skin test results.
Article
Pharmacology & Pharmacy
David M. Lehmann, Mikayla D. Armstrong, Wanda C. Williams, Cristina Postigo, Jane E. Simmons
Summary: The study revealed that water disinfected in the presence of four different ICM did not cause significant skin irritation or effects consistent with skin sensitization at the concentrations tested.
Article
Pharmacology & Pharmacy
Huiyan Jiang, Yuan Li, Xiaoyan Wu, Hongming Yu, Xin Zhang, Weihong Ge, Simin Yan
Summary: Establishing a risk management service system led by pharmacists to identify and assess personalized risks, provide early warning, prevention, and management of adverse reactions caused by iodinated contrast media, and reduce patient harm.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Lakshmi Ananthakrishnan, Daniel T. Parrott, Nathan Mielke, Yin Xi, Matthew S. Davenport
Summary: The study aimed to assess the accuracy of electronic health record prompts for premedication and found that errors in these prompts resulted in inappropriate premedication for some patients. These errors were primarily due to inaccurate coding, incomplete data, and misclassification of reactions.
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY
(2021)
Review
Allergy
Davide Caimmi, Pascal Demoly
Summary: Allergen immunotherapy (AIT) is a possible add-on treatment for asthmatic patients, proven to reduce symptoms and medication use. It can also be used as a preventive strategy to reduce the risk of developing asthma in patients with allergic rhinitis. Further research is needed to provide more precise indications for the role of AIT in clinical practice.
ALLERGY AND ASTHMA PROCEEDINGS
(2022)
Article
Allergy
Luciana Kase Tanno, Nicolas Molinari, Isabella Annesi-Maesano, Pascal Demoly, Ana Luiza Bierrenbach
Summary: This study is the first national population-based study of anaphylaxis hospital admissions in Brazil, using data from a low- or middle-income country. Hospital admissions and fatalities from anaphylaxis in Brazil appear to be increasing.
CLINICAL AND EXPERIMENTAL ALLERGY
(2022)
Review
Biotechnology & Applied Microbiology
Leticia de las Vecillas, Davide Caimmi, Ghislaine Annie Clarisse Isabwe, Ricardo Madrigal-Burgaleta, Ozge Soyer, Luciana Tanno, Alessandra Vultaggio, Mattia Giovannini, Francesca Mori
Summary: Hypersensitivity reactions to biologics in children are poorly understood, and there is a lack of knowledge on management and standardization of protocols. Recent publications have provided insights into managing these reactions and adapting desensitization protocols for pediatric populations. An international consensus is needed to improve personalized management and tailored desensitization in children.
EXPERT OPINION ON BIOLOGICAL THERAPY
(2023)
Article
Allergy
Anouchka Fillard, Amelia Licari, Nicolas Molinari, GianLuigi Marseglia, Pascal Demoly, Davide Caimmi
Summary: It is crucial to have a robust diagnosis of asthma in children to optimize patient care and reduce its burden. The recommended criterion of a 12% improvement in forced expiratory volume in 1 second (FEV1) after a bronchodilation test is rarely confirmed in clinical practice. This study found that a combination of clinical symptoms has a better sensitivity in diagnosing pediatric asthma compared to spirometric parameters.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2023)
Article
Allergy
Subhabrata Moitra, Marzia Simoni, Sandra Baldacci, Sara Maio, Anna Angino, Patrizia Silvi, Giovanni Viegi, Stefania La Grutta, Franco Ruggiero, Gianni Bedini, Francesca Natali, Lorenzo Cecchi, Uwe Berger, Maria Prentovic, Amir Gamil, Nour Baiz, Michel Thibaudon, Samuel Monnier, Davide Caimmi, Luciana K. Tanno, Pascal Demoly, Simone Orlandini, Isabella Annesi-Maesano
Summary: Allergic rhinitis (AR) is a major non-communicable disease that affects patients' quality of life. This study found that AR patients with comorbid asthma have poorer HRQoL and symptom control, especially those with severe asthma. A comprehensive approach is important for the management of AR patients with comorbid allergic conditions.
CLINICAL AND TRANSLATIONAL ALLERGY
(2023)
Article
Allergy
Oliver Pfaar, Philippe Devillier, Jochen Schmitt, Pascal Demoly, Ole Hilberg, Lawrence DuBuske, Nicole Hass, Ted Klok, Caroline Beutner
Summary: The 'Adherence and Persistence in AIT (APAIT)' checklist has been developed as a guide for reporting, designing, and interpreting retrospective studies on adherence or persistence to allergen immunotherapy (AIT). The checklist highlights the importance of transparency in reporting and identifies potential sources of bias in these studies.
Review
Medicine, General & Internal
E. Clark, M. Tabardel, Y. Bouderbala, P. Demoly, D. Caimmi
Summary: Pediatric asthma is a common chronic condition in childhood with an unsatisfactory definition. Diagnosis is based on clinical history, symptoms, and objective measures. Most children respond well to conventional treatments, but some require specialist consultation and potential biological therapy for severe asthma.
BULLETIN DE L ACADEMIE NATIONALE DE MEDECINE
(2023)
Article
Allergy
Davide Caimmi, Pablo Rodriguez del Rio, Pilar Rico, Carmen Vidal, Carmen Moreno, Thomas B. Casale, Pascal Demoly, Moises A. Calderdon
Summary: Allergen immunotherapy (AIT) is the only etiological therapy for respiratory allergic diseases. The CHOICE-Global Survey aims to study the key parameters that drive the prescription of AIT by doctors and the acceptance of AIT by patients. This survey will provide academic information on the drivers of AIT prescription in real-life practice, improving understanding of this therapy.
WORLD ALLERGY ORGANIZATION JOURNAL
(2023)
Review
Health Care Sciences & Services
Antoine Magnan, Jean-Francois Nicolas, Davide Caimmi, Marc Vocanson, Thierry Haddad, Luc Colas, Silvia Scurati, Laurent Mascarell, Mohamed H. Shamji
Summary: Like in many fields of medicine, the concept of precision dosing has re-emerged in routine practice in allergology. Only one retrospective study on French physicians' practice has addressed this topic so far and generated preliminary data supporting dose adaptation, mainly based on experience, patient profile understanding and response to treatment. We focus on key immune cells involved in allergic disease and its resolution to further understand the effect of allergen immunotherapy (AIT) on these cells, and discuss the eligibility of a non/low-responder subset for dose adaptation.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Anesthesiology
Paul Michel Mertes, Nadine Petitpain, Charles Tacquard, Marion Delpuech, Cedric Baumann, Jean Marc Malinovsky, Dan Longrois, Aurelie Gouel-Cheron, Diane Le Quang, Pascal Demoly, Jean Louis Gueant, Pierre Gillet, ALPHO Study Grp
Summary: This study assessed the relationship between pholcodine exposure and NMBA-related anaphylaxis. It found that exposure to pholcodine and other quaternary ammonium compounds in the environment can increase sensitivity to NMBAs. Pholcodine and quaternary ammonium sIgEs have a high negative predictive value but a very low positive predictive value for identifying NMBA-related reactions.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Allergy
Davide Caimmi, Evangeline Clark, Paul Fogel, Nicolas Heddebaut, Michel Aubier, Pascal Demoly
Summary: In this study, we found that Puressentiel (R) nasal protection spray (SNPA) is effective in reducing nasal symptoms in patients with allergic rhinitis, providing a natural non-pharmacological option.
INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
(2023)
Article
Allergy
Evangeline Clark, Luciana Kase Tanno, Tram Vo, Brigitte Blanc, Pascal Demoly, Davide Caimmi
Summary: This study aimed to assess the appropriateness of epinephrine use in children with allergies in the emergency department, and identify factors associated with epinephrine administration, auto-injector prescription, and referral to an allergist. The study found that only 17% of children received epinephrine injections and 57.1% consulted an allergist after the acute episode. This highlights the need for improved management and care pathways for pediatric anaphylaxis.
CLINICAL AND TRANSLATIONAL ALLERGY
(2023)
Article
Allergy
Pablo Rodriguez del Rio, Davide Caimmi, Pilar Rico Nieto, Carmen Vidal, Carmen Moreno, Maria Teresa Gonzalez-Fernandez, Margarita Tomas-Perez, Ana Beristain, Isa Bosse, Hoai Bich Trinh, Thomas B. Casale, Pascal Demoly, Moises A. Calderon, on behalf of the C. H. O. I. C. E. Survey Team CHOICE Survey Team
Summary: This study investigated the drivers of prescription for allergen immunotherapy (AIT) for respiratory allergic diseases. The results showed that there are multiple drivers for AIT prescription, including the characteristics of doctors and patients as well as the disease characteristics.
WORLD ALLERGY ORGANIZATION JOURNAL
(2023)
Review
Medicine, General & Internal
Carla Mastrorilli, Stefania Arasi, Simona Barni, Davide Caimmi, Fernanda Chiera, Pasquale Comberiati, Giulio Dinardo, Arianna Giannetti, Marco Gismondi, Serena Gracci, Francesco Paravati, Umberto Pelosi, Michele Miraglia Del Giudice, Roberto Bernardini, Luca Pecoraro
Summary: Fish allergy is one of the nine major triggers of allergic reactions. It affects less than 1% of the global population, but has a higher prevalence in children. Parvalbumin is the primary allergen found in fish muscles, and sensitization usually occurs through ingestion. Diagnosis involves history collection, prick tests, and measurement of serum-specific IgE. Clinical management includes avoidance of triggering species and having an action plan for accidental exposures.
MEDICINA-LITHUANIA
(2023)
Meeting Abstract
Allergy
Barbara Kong-Cardoso, Teresa Moscoso, Mario Morais-Almeida, Gregoire Mercier, Pascal Demoly, Luciana Kase Tanno
CLINICAL AND EXPERIMENTAL ALLERGY
(2022)