Contrast allergies for neurological imaging: When to proceed

Anna Fusco; Logan Pucci; Kevin Pierre; Adam Wolberg; Coulter Small; John Cerillo; Mohammad Reza Hosseini Siyanaki; Brandon Lucke-Wold; Anna Fusco; Logan Pucci; Kevin Pierre; Adam Wolberg; Coulter Small; John Cerillo; Mohammad Reza Hosseini Siyanaki; Brandon Lucke-Wold

doi:10.3934/Allergy.2022016

AIMS Allergy and Immunology

2022, Volume 6, Issue 4: 216-227. doi: 10.3934/Allergy.2022016

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Mini review

Contrast allergies for neurological imaging: When to proceed

1.
University of Florida, College of Medicine, Gainesville, Florida, USA
2.
University of Central Florida/Department of Surgery, HCA Florida Ocala Hospital, Ocala, Florida, USA
3.
Department of Radiology, HCA Florida Trinity Hospital, Trinity, Florida, USA
4.
College of Osteopathic Medicine, Nova Southeastern University, Clearwater, Florida, USA
5.
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA

Received: 19 July 2022 Revised: 29 September 2022 Accepted: 12 October 2022 Published: 17 October 2022

Contrast-enhanced neuroimaging is often necessary for the diagnosis and care of patients with diseases of the central nervous system. Although contrast is generally well tolerated and allergy to contrast is rare, allergic reactions can be severe and life threatening. Therefore, physicians should take care to prevent severe contrast allergy. In this review, we will discuss contrast allergy as well as potential strategies to reduce the risk of severe reactions in patients who require neuroimaging techniques with contrast. First, we discuss the clinical presentation and pathogenesis of contrast allergy and the risk factors associated with reactions. We then review methods to reduce the risk of future contrast reactions through improved patient education and documentation strategies, use of alternate imaging modalities or contrast media, premedication, and desensitization.
- contrast,
- allergies,
- neurologic imaging,
- protocols,
- allergy preparation
Citation: Anna Fusco, Logan Pucci, Kevin Pierre, Adam Wolberg, Coulter Small, John Cerillo, Mohammad Reza Hosseini Siyanaki, Brandon Lucke-Wold. Contrast allergies for neurological imaging: When to proceed[J]. AIMS Allergy and Immunology, 2022, 6(4): 216-227. doi: 10.3934/Allergy.2022016

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Abstract

Contrast-enhanced neuroimaging is often necessary for the diagnosis and care of patients with diseases of the central nervous system. Although contrast is generally well tolerated and allergy to contrast is rare, allergic reactions can be severe and life threatening. Therefore, physicians should take care to prevent severe contrast allergy. In this review, we will discuss contrast allergy as well as potential strategies to reduce the risk of severe reactions in patients who require neuroimaging techniques with contrast. First, we discuss the clinical presentation and pathogenesis of contrast allergy and the risk factors associated with reactions. We then review methods to reduce the risk of future contrast reactions through improved patient education and documentation strategies, use of alternate imaging modalities or contrast media, premedication, and desensitization.

Disclaimer

This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the authors and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

Conflict of interest

The authors declare no conflict of interest.

Author contributions

Anna Fusco, Logan Pucci, and Kevin Pierre made final revisions. Adam Wolberg wrote the first draft for the section reviewing iodinated contrast for CT. Coulter Small wrote the first draft of the introduction section. John Cerillo wrote the first draft of the allergy preparation and pre-medication section. Mohammad Reza Hosseini wrote the first draft of the section discussing gadolinium contrast for MRI. Brandon Lucke-Wold formulated the initial paper outline and made final revisions.

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