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Validation of Practical Pathway in Patients With Anaphylaxis to Low Osmolar Contrast Media: A Retrospective Cohort Study
DC Field | Value | Language |
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dc.contributor.author | Ahn, Kyung-Min | - |
dc.contributor.author | Ahn, Yoon Hae | - |
dc.contributor.author | Cho, Min Kyoung | - |
dc.contributor.author | Kang, Dong Yoon | - |
dc.contributor.author | Lee, Suh Young | - |
dc.contributor.author | Kang, Hye Ryun | - |
dc.date.accessioned | 2023-01-02T08:02:20Z | - |
dc.date.available | 2023-01-02T08:02:20Z | - |
dc.date.created | 2022-12-05 | - |
dc.date.issued | 2022-10 | - |
dc.identifier.citation | Journal of Allergy and Clinical Immunology: In Practice, Vol.10 No.10, pp.2685-2692.e2 | - |
dc.identifier.issn | 2213-2198 | - |
dc.identifier.uri | https://hdl.handle.net/10371/188782 | - |
dc.description.abstract | BACKGROUND: An optimal strategy for choosing safe alternative low osmolar contrast media (LOCM) has not yet been established in patients with a history of LOCM-induced anaphylaxis. OBJECTIVES: To validate the practical pathway in patients with anaphylaxis to LOCMs and to compare 2 different doses of challenge testing with skin test-negative LOCM. METHODS: A retrospective cohort study was performed in patients with LOCM-induced anaphylaxis. Patients were challenged with intravenous LOCMs showing negativity in the skin test according to 2 different protocols: low-dose and high-dose (maximum dose 10 and 30 mL, respectively). Challenge-negative LOCMs were selected for use during computed tomography scans, and patients received intravenous pretreatment with 4 mg chlorpheniramine and 40 mg methylprednisolone. RESULTS: Of the 110 challenge tests, there were 4 (3.6%) positive challenges. Among 106 enhanced computed tomography scans performed using challenge-negative LOCMs, breakthrough reactions occurred in 8 (7.6%). Breakthrough reaction rates were not statistically different between the 2 protocols (8.9% and 6.0% in the low-dose challenge and the high-dose challenge, respectively). Compared with the low-dose protocol, the number needed to test of the high-dose challenge test decreased 2.5-fold. Moreover, none of the patients in the high-dose challenge group incurred severe reactions during computed tomography scans with challenge-negative LOCM, whereas 80% of reactions were severe in the low-dose challenge group. CONCLUSIONS: We validated a pathway consisting of a battery of skin testing to LOCMs and challenge with skin test-negative LOCM in patients with LOCM-induced anaphylaxis. (C) 2022 American Academy of Allergy, Asthma & Immunology | - |
dc.language | 영어 | - |
dc.publisher | Elsevier | - |
dc.title | Validation of Practical Pathway in Patients With Anaphylaxis to Low Osmolar Contrast Media: A Retrospective Cohort Study | - |
dc.type | Article | - |
dc.identifier.doi | 10.1016/j.jaip.2022.03.030 | - |
dc.citation.journaltitle | Journal of Allergy and Clinical Immunology: In Practice | - |
dc.identifier.wosid | 000882886300025 | - |
dc.identifier.scopusid | 2-s2.0-85129878702 | - |
dc.citation.endpage | 2692.e2 | - |
dc.citation.number | 10 | - |
dc.citation.startpage | 2685 | - |
dc.citation.volume | 10 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Kang, Hye Ryun | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
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