Cookie Notice

This site uses cookies. By continuing to browse this site, you are agreeing to our use of cookies. Review our cookies information for more details.

skip to main content

Prescreening intradermal skin tests cannot predict hypersensitivity reactions to iodinated contrast media

Published online: August 10, 2019

Hypersensitivity reaction to iodinated contrast media (ICM) is a persistent clinical issue due to widespread use of computed tomography (CT) examinations. Whether routinely performing intradermal skin tests (IDT) can predict hypersensitivity reactions is an unresolved question.

In a recently published article in The Journal of Allergy and Clinical Immunology: In Practice, Lee et al. reported the results of a prospective study evaluating the role of IDT as a screening test of hypersensitivity reactions to ICM. Fifteen (0.5%) of the 2,843 patients had a positive IDT result before their scheduled CT scan; however, none of these patients experienced a hypersensitivity reaction after administration of full-dose ICM. In contrast, nineteen patients who experienced hypersensitivity reactions after ICM challenge had a negative IDT result. The sensitivity and positive predictive value of IDT for ICM were both 0%.

In short, prescreening intradermal skin testing before CT imaging has no clinical value as a tool for predicting hypersensitivity reaction to ICM, and thus should not be performed routinely.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

Full Article