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Shellfish allergy and relation to iodinated contrast media: United Kingdom survey

查看全文 作  者:Mudassar [1]Baig;Ahmad [2]Farag;Jamal [2]Sajid;Rahul [3]Potluri;R Bruce [2]Irwin;Hafiz Mohammed Idrees [2]Khalid 高影响力作者 机构地区:[1]Lancashire Cardiac Centre,Blackpool Victoria Hospital,Blackpool,Lancashire FY3 8NR,United Kingdom;[2]Cardiology Department,Fairfield Hospital Bury,Pennine Acute Trust,Lancashire BL9 7TD,United Kingdom;[3]ACALM Study Unit in partnership with School of Medical Sciences,Aston University,Birmingham B4 7ET,United Kingdom高影响力机构 出  处:《World Journal of Cardiology》索引2014年第6卷第3期,共5页高影响力期刊 摘  要:AIM: To assess current practice of United Kingdom cardiologists with respect to patients with reported shellfish/iodine allergy, and in particular the use of iodinated contrast for elective coronary angiography.Moreover we have reviewed the current evidence-base and guidelines available in this area.METHODS: A questionnaire survey was send to 500senior United Kingdom cardiologists(almost 50% cardiologists registered with British Cardiovascular Society)using email and first 100 responses used to analyze practise. We involved cardiologists performing coronary angiograms routinely both at secondary and tertiary centres. Three specific questions relating to allergy were asked:(1) History of shellfish/iodine allergy in pre-angiography assessment;(2) Treatments offeredfor shellfish/iodine allergy individuals; and(3) Any specific treatment protocol for shellfish/iodine allergy cases. We aimed to establish routine practice in United Kingdom for patients undergoing elective coronary angiography. We also performed comprehensive PubMed search for the available evidence of relationship between shellfish/iodine allergy and contrast media.RESULTS: A total of 100 responses were received, representing 20% of all United Kingdom cardiologists. Ninety-three replies were received from consultant cardiologists, 4 from non-consultant grades and 3 from cardiology specialist nurses. Amongst the respondents, 66% routinely asked about a previous history of shellfish/iodine allergy. Fifty-six percent would pre-treat these patients with steroids and anti-histamines. The other 44% do nothing, or do nonspecific testing based on their personal experience as following:(1) Skin test with 1 mL of subcutaneous contrast before intravenous contrast;(2) Test dose 2 mL contrast before coronary injection;(3) Close observation for shellfish allergy patients; and(4) Minimal evidence that the steroid and anti-histamine regime is effective but it makes us feel better.CONCLUSION: There is no evidence that allergy to shellfish alters the risk of reaction to intravenous contrast more than any other allergy and asking about such allergies in pre-angiogram assessment will not provide any additional information except propagating the myth. 关 键 词:SHELLFISH ALLERGY CONTRAST ALLERGY Iodinated CONTRAST ALLERGY Low OSMOLARITY CONTRAST MEDIA High OSMOLARITY CONTRAST MEDIA Pre-angiography assessment
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