Immediate Hypersensitivity to Contrast Agents: The French 5-year CIRTACI Study - Université de Montpellier
Article Dans Une Revue EClinicalMedicine Année : 2018

Immediate Hypersensitivity to Contrast Agents: The French 5-year CIRTACI Study

Olivier Clément (1, 2) , Pascale Dewachter , Claudie Mouton-Faivre (3) , Camille Nevoret (4) , Laurence Guilloux (5) , Evelyne Bloch Morot (6) , Sandrine Katsahian (4) , Dominique Laroche (7) , Martine Audebert (8) , Béatrice Benabes-Jezraoui (8) , Yves Benoit (9) , Sylvie Beot (3) , Frédéric Bérard (10) , Yves Berthezène (11) , Philippe Bertrand (12) , Juliette Bouffard (13) , Jean-Luc Bourrain (14) , Bruno Boyer (15) , Marie-France Carette (16) , Christine Caron-Poitreau (17) , Béatrice Cavestri (18) , Jean Pierre Cercueil (19) , Denis-André Charpin (20) , Evelyne Collet (21) , Arielle Crombe-Ternamian (9) , Jacques Dalmas (22) , Eric Decoux (23) , Marie-France Defrance (24) , Yvonne Delaval (25) , Pascal Demoly (23, 26) , Claude Depriester , Pascale Depriester (8) , Alain Didier (27) , Martine Drouet (17) , Benoît Dupas (28) , Dominique Dupre-Goetchebeur (29) , Charles Dzviga (30) , Christine Fabre (31, 32) , Gilbert R. Ferretti (33) , Corinne Fourre-Jullian (22) , Pascal Girardin (34) , Jacques Giron (35) , Marion Gouitaa (20) , Nicolas Grenier (36) , Lydie Guenard Bilbault (3) , Stéphane Guez (36) , Nathalie Gunera-Saad , Jean-François Heautot (37) , Dominique Herbin (38) , Cyrille Hoarau (39) , Claude Jacquot (40) , Christian Julien (38) , Laurent Laborie (34) , Claude Lambert (41) , Pascal Larroche (42) , Xavier Leclerc (43) , Laurent Lemaître (44) , Francisque Leynadier (16) , Agnès Lillo-Le-Louet (4) , Jean-Pierre Louvel (45) , Nathalie Louvier (46) , Marie-Madeleine Lucas (25) , Geneviève Meites (35) , Nicolas Mennesson (9) , Liliane Metge (31) , Yannick Meunier (47) , Laurence Monnier-Cholley (48) , Mariano Musacchio (49) , Brigitte Nicolie (17) , Gisèle Occelli (50) , Hélène Oesterle (49) , Francine Paisant-Thouveny (17) , Michel Panuel (20) , Nadine Railhac (35) , Frédérique Rety-Jacob (13) , Cécile Rochefort-Morel (25) , Catherine Roy (51) , Philippe Sarlieve (34) , Musa Sesay (36) , Catherine Sgro (52) , Patrice Taourel (23, 26) , Patrick Terrier (53) , Odile Theissen (49) , Ingrid Topenot (9) , Jocelyne Valfrey (51) , Francis Veillon (54) , Marie-Claude Vergnaud (55) , Charles Veyret (30) , Denis Vincent (31) , Benoit Wallaert (56) , François Wessel (57) , Marc Zins (24)
1 Service de Radiologie [CHU HEGP]
2 PARCC - UMR-S U970 - Paris-Centre de Recherche Cardiovasculaire
3 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
4 HEGP - Hôpital Européen Georges Pompidou [APHP]
5 Biomnis Laboratory
6 Service de Médecine Interne [CHU HEGP]
7 CHU Caen
8 CHU Amiens-Picardie
9 Hôpital Edouard Herriot [CHU - HCL]
10 Service d'immunologie [Centre Hospitalier Lyon Sud - HCL]
11 Hôpital de la Croix-Rousse [CHU - HCL]
12 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
13 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
14 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
15 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
16 CHU Tenon [AP-HP]
17 CHU Angers - Centre Hospitalier Universitaire d'Angers
18 Hôpital Albert Calmette
19 Service de radiologie et d'Imagerie médicale diagnostique et thérapeutique (CHU de Dijon)
20 Hôpital Nord [CHU - APHM]
21 Service de Dermatologie (CHU de Dijon)
22 CH Martigues
23 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
24 Centre hospitalier Saint-Joseph [Paris]
25 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
26 UM - Université de Montpellier
27 Service de pneumologie [Toulouse]
28 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
29 CHU - BREST - Hôpital Morvan - CHRU de Brest
30 Service de Radiologie [CHU Saint-Etienne]
31 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
32 INM - Institut des Neurosciences de Montpellier
33 Service central de radiologie et d'imagerie médicale
34 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
35 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
36 Hôpital Pellegrin
37 Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes]
38 CHPC - CH Centre Hospitalier Public du Cotentin
39 Service de néphrologie et immunologie clinique [CHRU Tours]
40 Clinique de réanimation médicale
41 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
42 DR - Brest - Département de radiologie [Brest]
43 Services de neuroradiologie [Lille]
44 Hôpital Claude Huriez [Lille]
45 Service de Radiologie [CHU Rouen]
46 UNICANCER/CRLCC-CGFL - Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon]
47 Service de Réanimation Médicale [CHU Rouen]
48 CHU Saint-Antoine [AP-HP]
49 Hôpital pasteur [Colmar]
50 CHU Nice - Centre Hospitalier Universitaire de Nice
51 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
52 Laboratoire de Pharmacologie-Toxicologie [CHU de Dijon]
53 Service de pneumologie, allergologie, mucoviscidose pédiatrique [Rouen]
54 Service de radiologie [Strasbourg]
55 Service de Médecine générale [CHU Caen]
56 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
57 Service de pneumologie [Nantes]
Pascale Dewachter
  • Fonction : Auteur
  • PersonId : 787179
  • IdRef : 14421895X
Dominique Laroche
  • Fonction : Auteur
Yves Berthezène
Evelyne Collet
  • Fonction : Auteur
  • PersonId : 1015058
Jacques Dalmas
  • Fonction : Auteur
Claude Depriester
  • Fonction : Auteur
Alain Didier
Nathalie Gunera-Saad
  • Fonction : Auteur
Musa Sesay
  • Fonction : Auteur
Marc Zins

Résumé

Background:Iodinated and gadolinium-based contrast media (ICM; GBCM) induce immediate hypersensitivity (IH) reactions. Differentiating allergic from non-allergic IH is crucial; allergy contraindicates the culprit agent for life. We studied frequency of allergic IH among ICM or GBCM reactors.Methods:Patients were recruited in 31 hospitals between 2005 and 2009. Clinical symptoms, plasma histamine and tryptase concentrations and skin tests were recorded. Allergic IH was diagnosed by intradermal tests (IDT) with the culprit CM diluted 1:10, "potentially allergic" IH by positive IDT with pure CM, and non-allergic IH by negative IDT.Findings:Among 245 skin-tested patients (ICM = 209; GBCM = 36), allergic IH to ICM was identified in 41 (19.6%) and to GBCM in 10 (27.8%). Skin cross-reactivity was observed in 11 patients with ICM (26.8%) and 5 with GBCM (50%). Allergy frequency increased with clinical severity and histamine and tryptase concentrations (p < 0.0001). Cardiovascular signs were strongly associated with allergy. Non-allergic IH was observed in 152 patients (62%) (ICM:134; GBCM:18). Severity grade was lower (p < 0.0001) and reaction delay longer (11.6 vs 5.6 min; p < 0.001). Potentially allergic IH was diagnosed in 42 patients (17.1%) (ICM:34; GBCM:8). The delay, severity grade, and mediator release were intermediate between the two other groups.Interpretation:Allergic IH accounted for < 10% of cutaneous reactions, and > 50% of life-threatening ones. GBCM and ICM triggered comparable IH reactions in frequency and severity. Cross-reactivity was frequent, especially for GBCM. We propose considering skin testing with pure contrast agent, as it is more sensitive than the usual 1:10 dilution criteria.
Fichier principal
Vignette du fichier
main.pdf (932.54 Ko) Télécharger le fichier
Origine Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-02304698 , version 1 (16-12-2023)

Identifiants

Citer

Olivier Clément, Pascale Dewachter, Claudie Mouton-Faivre, Camille Nevoret, Laurence Guilloux, et al.. Immediate Hypersensitivity to Contrast Agents: The French 5-year CIRTACI Study. EClinicalMedicine, 2018, 1, pp.51-61. ⟨10.1016/j.eclinm.2018.07.002⟩. ⟨hal-02304698⟩
412 Consultations
27 Téléchargements

Altmetric

Partager

More