IntroductionFor patients with a known history of hypersensitivityreactions to radiocontrast media (RCM), premedicationwith antihistamines and corticosteroids before receivingRCM is recommended. It has been shown that such premedicationdecreases the frequency of mild and aggregateallergic like reactions. However, premedication doesnot prevent all subsequent reactions.ObjectivesWe investigate the effectiveness of premedication forhypersensitivity reactions to radiocontrast media (RCM)in one tertiary hospital.MethodsWe reviewed electronic medical records of all thepatients who had been prescribed premedication withsystemic steroid or antihistamine for hypersensitivityreactions to RCM from January 2009 to January 2012 inSeoul National University Hospital. Data of previoushypersensitivity reactions and reactions after re-exposureto RCM with premedication was extracted.ResultsA total of 401 patients with a history of hypersensitivityreaction to RCM and were premedicated at re-exposureto RCM. Male was 177 (44.1%) and mean age was55.83??11.92 years. Most common hypersensitivity symptomwas urticaria (259, 64.6%), followed by itching(36.7%), rash (21.4%) and angioedema (13.2%). Hypotensionwas reported in 9 (2.2%) and syncope 5 (1.2%). Systemicsteroid was prescribed in 143 patients (35.4%).After premedication, 139 patients (77.7%) had no hypersensitivityreactions to re-exposed RCM. Incidence ofsymptom after premedication such as uriticaria (12.4%),itching (5.6%), rash (5.1%), angioedema (2.2%) were significantlydecreased compared with previous incidence(P0.05)ConclusionThe use of corticosteroid or antihistamine beforeadministration of RCM may diminish the overall prevalenceof reactions. Randomized controlled studies of theeffects of pretreatment in patients with hypersensitivityreaction to RCM were needed.
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