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. 2022 Mar 17:3:813927.
doi: 10.3389/falgy.2022.813927. eCollection 2022.

Hypersensitivity to Gadolinium-Based Contrast Media

M Teresa Gracia Bara  1   2 , Alicia Gallardo-Higueras  1 , Esther M Moreno  1   2   3   4 , Elena Laffond  1   2   3 , Francisco J Muñoz Bellido  1   2   3 , Cristina Martin  1   2 , Miriam Sobrino  1   2 , Eva Macias  1   2   3 , Sonia Arriba-Méndez  1   2   3 , Rosita Castillo  1 , Ignacio Davila  1   2   3   4
Affiliations

Hypersensitivity to Gadolinium-Based Contrast Media

M Teresa Gracia Bara et al. Front Allergy. .

Abstract

Gadolinium-based contrast agents (GBCAs) are frequently used in magnetic resonance imaging (MRI) examinations to increase sensitivity in diagnoses. Recently, an increase in the description of hypersensitivity reactions to GBCAs has been detected. We performed research in PubMed, PubMed, SCOPUS, and EMBASE until September 2021, searching for studies regarding immediate and delayed hypersensitivity reactions to gadolinium-based contrast agents in which an allergy study was performed. The initial research identified 149 articles written in English. After excluding articles duplicated and articles that had irrelevant designs, 26 articles were included. Finally, 17 studies concerning immediate reactions, six studies concerning non-immediate reactions, and three concerning both that performed allergy evaluations were selected. In the review, we analyzed the characteristics of immediate and delayed reactions and the results of the allergy study and cross-reactivity. Skin tests seem to have acceptable accuracy, but drug provocation tests are still needed when skin tests are negative o to find alternative agents. Although cross-reactivity patterns are not well established, cross-reactivity seems to exist among macrocyclic agents. Notwithstanding, the number of patients analyzed is low and further studies are required. A management algorithm is suggested.

Keywords: allergy; gadolinium based contrast agent; hypersensitivity; immediate reactions; non-immediate reactions; skin test.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Classification of gadolinium based contrast agents (GBCAs)(-concentration of available GBCAs-).
Figure 2
Figure 2
Flow diagram for search methods.
Figure 3
Figure 3
Algorithm for the diagnosis of hypersensitivity reactions to GBCAs. DPT, drug provocation test; GBCA, gadolinium-based contrast agent; SCAR, severe cutaneous reaction.
See this image and copyright information in PMC

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