Hipersensibilidad a medios de contraste yodado: estrategias diagnósticas y terapéuticas. Posicionamiento del Comité de Alergia a Medicamentos de Colegio Mexicano de Inmunología Clínica y Alergia.
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| Title: | Hipersensibilidad a medios de contraste yodado: estrategias diagnósticas y terapéuticas. Posicionamiento del Comité de Alergia a Medicamentos de Colegio Mexicano de Inmunología Clínica y Alergia. |
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| Alternate Title: | Hypersensitivity to iodinated contrast media: Diagnostic and therapeutic strategies. Position Statement of the Drug Allergy Committee of the Mexican College of Clinical Immunology and Allergy. |
| Authors: | Villarreal González, Rosalaura Virginia1,2, Flores García, Nataly Anais2, Astrid de la Fuente, Leslie1 leslieastridd@gmail.com, Fraga Olvera, Alira3, Ávila Lara, Anabel4, Montiel Sierra, Ana Judith5, Robledo Martínez, Angelina Ingrid6, Correa Serrano, Carlos Alberto2, García Rosas, Carolina7, Alonso Bello, César Daniel8, Rico Solís, Germán Agustín9, Ochoa García, Itzel Vianey10, Jimenez Sandoval, Jaime Omar11, Ramírez Heredia, Jennifer12, González Juárez, Kitzia13, Moreno González, Maciel Monserrat14, Ortega Cisneros, Margarita10, de la Luz Hortensia García Cruz, María15, Arias Martínez, María Isabel16, Hernández Ojeda, Mariana17 |
| Source: | Revista Alergia de Mexico. ene-mar2026, Vol. 73 Issue 1, p76-92. 17p. |
| Subjects: | CONTRAST media, THERAPEUTICS, ALLERGIES, CROSS reactions (Immunology), DIAGNOSIS, DISEASE risk factors, IMMUNE system, PREMEDICATION |
| Abstract (English): | BACKGROUND: Hypersensitivity reactions to iodinated contrast media represent a relevant clinical issue due to their increasing use in radiodiagnostic procedures. These reactions are classified as immediate or non-immediate, immunological and non-immunological, with variable prevalence and potentially serious consequences such as anaphylaxis or severe cutaneous adverse reactions. Identifying risk factors, classification, and immunological mechanisms of iodinated contrast media enables the development of effective prevention and management strategies. OBJECTIVE: To analyze the chemical characteristics of iodinated contrast media, the associated immunological mechanisms, and available diagnostic tools to establish effective strategies for the prevention, diagnosis, and management of hypersensitivity reactions in both general and vulnerable populations. METHODOLOGY: A literature review was conducted analyzing the different types of contrast media according to their chemical structure, osmolarity, osmolality, and viscosity, highlighting their association with the risk of hypersensitivity reactions. The immunological mechanisms involved are described, including IgE-mediated responses, T-cell–mediated reactions, and activation of the MRGPRX2 receptor. Diagnostic tools such as in vivo, in vitro tests, and controlled exposure tests were examined in terms of sensitivity, specificity, and clinical utility. Cross-reactivity between iodinated contrast media agents and the usefulness of grouping them based on chemical characteristics to guide the selection of safer alternatives were addressed. Finally, therapeutic and preventive strategies were reviewed, including premedication protocols, iodinated contrast media selection, and special considerations for vulnerable populations such as pediatric patients, pregnant women, and older adults. CONCLUSIONS: Hypersensitivity to iodinated contrast media requires a multidisciplinary diagnostic and therapeutic approach based on accurate characterization of the reaction, immunological assessment, and personalized selection of contrast agents. Current knowledge allows for a significant reduction in HSR recurrence through substitution of the culprit agent and/or appropriate premedication, thereby improving the safety of contrast-enhanced diagnostic procedures. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | ANTECEDENTES: Las reacciones de hipersensibilidad a medios de contraste yodados representan un problema clínico relevante debido al uso creciente para estudios radiodiagnósticos. Estas reacciones se clasifican en inmunológicas inmediatas, no inmediatas y no inmunológicas, con una prevalencia variable y potenciales consecuencias graves (anafilaxia o reacciones adversas cutáneas graves). La identificación de factores de riesgo, clasificación y mecanismos inmunológicos de los medios de contraste permiten establecer estrategias de prevención y tratamiento. OBJETIVO: Analizar las características químicas de los medios de contraste, mecanismos inmunológicos y métodos diagnósticos disponibles, con la finalidad de establecer estrategias efectivas para su prevención, diagnóstico y tratamiento en poblaciones generales y vulnerables. MÉTODOLOGÍA: Se efectuó una revisión bibliográfica donde se analizaron los diferentes tipos de medios de contraste, según su estructura química, osmolaridad, osmolalidad y viscosidad, destacando su asociación con el riesgo de reacciones de hipersensibilidad. Se describen los mecanismos inmunológicos implicados, incluyendo respuestas mediadas por IgE, células T y el receptor MRGPRX2. Se detallan métodos diagnósticos: estudios in vivo e in vitro, y prueba de exposición controlada, evaluando la sensibilidad, especificidad y utilidad clínica. Se puntualiza la reactividad cruzada entre medios de contraste y la utilidad de agruparlos según sus características químicas para elegir alternativas seguras. Finalmente, se abordan estrategias terapéuticas y preventivas, como la premedicación, la selección del medio de contraste y las consideraciones especiales en poblaciones vulnerables (pacientes pediátricos, mujeres embarazadas y adultos mayores). CONCLUSIONES: La hipersensibilidad a medios de contraste requiere un enfoque diagnóstico y terapéutico multidisciplinario, basado en la adecuada caracterización de la reacción, estudios inmunológicos y selección personalizada del medio de contraste que de administrará. El conocimiento actual permite reducir significativamente la recurrencia de reacciones de hipersensibilidad mediante la sustitución del agente implicado y/o premedicación, optimizando así la seguridad de los procedimientos diagnósticos asociados con medios de contraste. [ABSTRACT FROM AUTHOR] |
| Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | MedicLatina |
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| Header | DbId: lth DbLabel: MedicLatina An: 192855048 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Hipersensibilidad a medios de contraste yodado: estrategias diagnósticas y terapéuticas. Posicionamiento del Comité de Alergia a Medicamentos de Colegio Mexicano de Inmunología Clínica y Alergia. – Name: TitleAlt Label: Alternate Title Group: TiAlt Data: Hypersensitivity to iodinated contrast media: Diagnostic and therapeutic strategies. Position Statement of the Drug Allergy Committee of the Mexican College of Clinical Immunology and Allergy. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Villarreal+González%2C+Rosalaura+Virginia%22">Villarreal González, Rosalaura Virginia</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Flores+García%2C+Nataly+Anais%22">Flores García, Nataly Anais</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Astrid+de+la+Fuente%2C+Leslie%22">Astrid de la Fuente, Leslie</searchLink><relatesTo>1</relatesTo><i> leslieastridd@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Fraga+Olvera%2C+Alira%22">Fraga Olvera, Alira</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Ávila+Lara%2C+Anabel%22">Ávila Lara, Anabel</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Montiel+Sierra%2C+Ana+Judith%22">Montiel Sierra, Ana Judith</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Robledo+Martínez%2C+Angelina+Ingrid%22">Robledo Martínez, Angelina Ingrid</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Correa+Serrano%2C+Carlos+Alberto%22">Correa Serrano, Carlos Alberto</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22García+Rosas%2C+Carolina%22">García Rosas, Carolina</searchLink><relatesTo>7</relatesTo><br /><searchLink fieldCode="AR" term="%22Alonso+Bello%2C+César+Daniel%22">Alonso Bello, César Daniel</searchLink><relatesTo>8</relatesTo><br /><searchLink fieldCode="AR" term="%22Rico+Solís%2C+Germán+Agustín%22">Rico Solís, Germán Agustín</searchLink><relatesTo>9</relatesTo><br /><searchLink fieldCode="AR" term="%22Ochoa+García%2C+Itzel+Vianey%22">Ochoa García, Itzel Vianey</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22Jimenez+Sandoval%2C+Jaime+Omar%22">Jimenez Sandoval, Jaime Omar</searchLink><relatesTo>11</relatesTo><br /><searchLink fieldCode="AR" term="%22Ramírez+Heredia%2C+Jennifer%22">Ramírez Heredia, Jennifer</searchLink><relatesTo>12</relatesTo><br /><searchLink fieldCode="AR" term="%22González+Juárez%2C+Kitzia%22">González Juárez, Kitzia</searchLink><relatesTo>13</relatesTo><br /><searchLink fieldCode="AR" term="%22Moreno+González%2C+Maciel+Monserrat%22">Moreno González, Maciel Monserrat</searchLink><relatesTo>14</relatesTo><br /><searchLink fieldCode="AR" term="%22Ortega+Cisneros%2C+Margarita%22">Ortega Cisneros, Margarita</searchLink><relatesTo>10</relatesTo><br /><searchLink fieldCode="AR" term="%22de+la+Luz+Hortensia+García+Cruz%2C+María%22">de la Luz Hortensia García Cruz, María</searchLink><relatesTo>15</relatesTo><br /><searchLink fieldCode="AR" term="%22Arias+Martínez%2C+María+Isabel%22">Arias Martínez, María Isabel</searchLink><relatesTo>16</relatesTo><br /><searchLink fieldCode="AR" term="%22Hernández+Ojeda%2C+Mariana%22">Hernández Ojeda, Mariana</searchLink><relatesTo>17</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Revista+Alergia+de+Mexico%22">Revista Alergia de Mexico</searchLink>. ene-mar2026, Vol. 73 Issue 1, p76-92. 17p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22CONTRAST+media%22">CONTRAST media</searchLink><br /><searchLink fieldCode="DE" term="%22THERAPEUTICS%22">THERAPEUTICS</searchLink><br /><searchLink fieldCode="DE" term="%22ALLERGIES%22">ALLERGIES</searchLink><br /><searchLink fieldCode="DE" term="%22CROSS+reactions+%28Immunology%29%22">CROSS reactions (Immunology)</searchLink><br /><searchLink fieldCode="DE" term="%22DIAGNOSIS%22">DIAGNOSIS</searchLink><br /><searchLink fieldCode="DE" term="%22DISEASE+risk+factors%22">DISEASE risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22IMMUNE+system%22">IMMUNE system</searchLink><br /><searchLink fieldCode="DE" term="%22PREMEDICATION%22">PREMEDICATION</searchLink> – Name: Abstract Label: Abstract (English) Group: Ab Data: BACKGROUND: Hypersensitivity reactions to iodinated contrast media represent a relevant clinical issue due to their increasing use in radiodiagnostic procedures. These reactions are classified as immediate or non-immediate, immunological and non-immunological, with variable prevalence and potentially serious consequences such as anaphylaxis or severe cutaneous adverse reactions. Identifying risk factors, classification, and immunological mechanisms of iodinated contrast media enables the development of effective prevention and management strategies. OBJECTIVE: To analyze the chemical characteristics of iodinated contrast media, the associated immunological mechanisms, and available diagnostic tools to establish effective strategies for the prevention, diagnosis, and management of hypersensitivity reactions in both general and vulnerable populations. METHODOLOGY: A literature review was conducted analyzing the different types of contrast media according to their chemical structure, osmolarity, osmolality, and viscosity, highlighting their association with the risk of hypersensitivity reactions. The immunological mechanisms involved are described, including IgE-mediated responses, T-cell–mediated reactions, and activation of the MRGPRX2 receptor. Diagnostic tools such as in vivo, in vitro tests, and controlled exposure tests were examined in terms of sensitivity, specificity, and clinical utility. Cross-reactivity between iodinated contrast media agents and the usefulness of grouping them based on chemical characteristics to guide the selection of safer alternatives were addressed. Finally, therapeutic and preventive strategies were reviewed, including premedication protocols, iodinated contrast media selection, and special considerations for vulnerable populations such as pediatric patients, pregnant women, and older adults. CONCLUSIONS: Hypersensitivity to iodinated contrast media requires a multidisciplinary diagnostic and therapeutic approach based on accurate characterization of the reaction, immunological assessment, and personalized selection of contrast agents. Current knowledge allows for a significant reduction in HSR recurrence through substitution of the culprit agent and/or appropriate premedication, thereby improving the safety of contrast-enhanced diagnostic procedures. [ABSTRACT FROM AUTHOR] – Name: Abstract Label: Abstract (Spanish) Group: Ab Data: ANTECEDENTES: Las reacciones de hipersensibilidad a medios de contraste yodados representan un problema clínico relevante debido al uso creciente para estudios radiodiagnósticos. Estas reacciones se clasifican en inmunológicas inmediatas, no inmediatas y no inmunológicas, con una prevalencia variable y potenciales consecuencias graves (anafilaxia o reacciones adversas cutáneas graves). La identificación de factores de riesgo, clasificación y mecanismos inmunológicos de los medios de contraste permiten establecer estrategias de prevención y tratamiento. OBJETIVO: Analizar las características químicas de los medios de contraste, mecanismos inmunológicos y métodos diagnósticos disponibles, con la finalidad de establecer estrategias efectivas para su prevención, diagnóstico y tratamiento en poblaciones generales y vulnerables. MÉTODOLOGÍA: Se efectuó una revisión bibliográfica donde se analizaron los diferentes tipos de medios de contraste, según su estructura química, osmolaridad, osmolalidad y viscosidad, destacando su asociación con el riesgo de reacciones de hipersensibilidad. Se describen los mecanismos inmunológicos implicados, incluyendo respuestas mediadas por IgE, células T y el receptor MRGPRX2. Se detallan métodos diagnósticos: estudios in vivo e in vitro, y prueba de exposición controlada, evaluando la sensibilidad, especificidad y utilidad clínica. Se puntualiza la reactividad cruzada entre medios de contraste y la utilidad de agruparlos según sus características químicas para elegir alternativas seguras. Finalmente, se abordan estrategias terapéuticas y preventivas, como la premedicación, la selección del medio de contraste y las consideraciones especiales en poblaciones vulnerables (pacientes pediátricos, mujeres embarazadas y adultos mayores). CONCLUSIONES: La hipersensibilidad a medios de contraste requiere un enfoque diagnóstico y terapéutico multidisciplinario, basado en la adecuada caracterización de la reacción, estudios inmunológicos y selección personalizada del medio de contraste que de administrará. El conocimiento actual permite reducir significativamente la recurrencia de reacciones de hipersensibilidad mediante la sustitución del agente implicado y/o premedicación, optimizando así la seguridad de los procedimientos diagnósticos asociados con medios de contraste. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.29262/ram.v73i1.1540 Languages: – Code: spa Text: Spanish PhysicalDescription: Pagination: PageCount: 17 StartPage: 76 Subjects: – SubjectFull: CONTRAST media Type: general – SubjectFull: THERAPEUTICS Type: general – SubjectFull: ALLERGIES Type: general – SubjectFull: CROSS reactions (Immunology) Type: general – SubjectFull: DIAGNOSIS Type: general – SubjectFull: DISEASE risk factors Type: general – SubjectFull: IMMUNE system Type: general – SubjectFull: PREMEDICATION Type: general Titles: – TitleFull: Hipersensibilidad a medios de contraste yodado: estrategias diagnósticas y terapéuticas. Posicionamiento del Comité de Alergia a Medicamentos de Colegio Mexicano de Inmunología Clínica y Alergia. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Villarreal González, Rosalaura Virginia – PersonEntity: Name: NameFull: Flores García, Nataly Anais – PersonEntity: Name: NameFull: Astrid de la Fuente, Leslie – PersonEntity: Name: NameFull: Fraga Olvera, Alira – PersonEntity: Name: NameFull: Ávila Lara, Anabel – PersonEntity: Name: NameFull: Montiel Sierra, Ana Judith – PersonEntity: Name: NameFull: Robledo Martínez, Angelina Ingrid – PersonEntity: Name: NameFull: Correa Serrano, Carlos Alberto – PersonEntity: Name: NameFull: García Rosas, Carolina – PersonEntity: Name: NameFull: Alonso Bello, César Daniel – PersonEntity: Name: NameFull: Rico Solís, Germán Agustín – PersonEntity: Name: NameFull: Ochoa García, Itzel Vianey – PersonEntity: Name: NameFull: Jimenez Sandoval, Jaime Omar – PersonEntity: Name: NameFull: Ramírez Heredia, Jennifer – PersonEntity: Name: NameFull: González Juárez, Kitzia – PersonEntity: Name: NameFull: Moreno González, Maciel Monserrat – PersonEntity: Name: NameFull: Ortega Cisneros, Margarita – PersonEntity: Name: NameFull: de la Luz Hortensia García Cruz, María – PersonEntity: Name: NameFull: Arias Martínez, María Isabel – PersonEntity: Name: NameFull: Hernández Ojeda, Mariana IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Text: ene-mar2026 Type: published Y: 2026 Identifiers: – Type: issn-print Value: 00025151 Numbering: – Type: volume Value: 73 – Type: issue Value: 1 Titles: – TitleFull: Revista Alergia de Mexico Type: main |
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