Management and Prevention of Hypersensitivity Reactions to Radiocontrast Media: A Consensus Statement from the American College of Radiology and the American Academy of Allergy, Asthma & Immunology

Authors

Carolyn Wang, Department of Radiology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195.
Allison Ramsey, Rochester Regional HealthFollow
David Lang, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio.
Ana Maria Copaescu, Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
Pranay Krishnan, Department of Clinical Radiology, MedStar Georgetown University Hospital, Washington, DC.
Merin Kuruvilla, Division of Pulmonary, Allergy, Critical Care, and Sleep, Emory University School of Medicine, Atlanta, Ga.
Benjamin Mervak, Department of Radiology, Michigan Medicine, Ann Arbor, Mich.
Jeffrey Newhouse, Department of Radiology and Urology, Columbia University Irving Medical Center, New York, NY.
Alisa Sumkin, RadNet.
Rebecca Saff, Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass.

Department

Allergy and Immunology

Document Type

Article

Publication Title

Radiology

Abstract

Intravenous iodinated contrast media (ICM) is widely used in the United States, and it is imperative to provide guidance on the management of adverse reactions to ICM as well as the preparation, planning, and potential premedication for patients with previous reactions. Currently there is a discordance between the American College of Radiology Contrast Manual, which recommends premedication to prevent repeat hypersensitivity reactions to ICM, and the Anaphylaxis 2020 Practice Parameters Update, which recommends against routine administration of glucocorticoids and/or antihistamines to prevent anaphylaxis with prior ICM hypersensitivity reactions. A task force of experts from radiology who are also members of the American College of Radiology Committee on Drugs and Contrast Media and expert allergists/immunologists including members of the Adverse Reactions to Drugs, Biologics and Latex Committee of American Academy of Allergy, Asthma & Immunology evaluated the scientific evidence to develop consensus recommendations that are endorsed by both organizations. The task force took into account the strength of evidence and balanced the potential risks of recurrent reactions with those of premedication and product avoidance when making these recommendations to improve and standardize the care of patients who experience or have a history of reaction to ICM.

First Page

e240100

DOI

10.1148/radiol.240100

Volume

315

Issue

2

Publication Date

5-1-2025

Medical Subject Headings

Contrast Media (adverse effects); Humans; Drug Hypersensitivity (prevention & control, therapy); United States; Consensus; Societies, Medical; Radiology; Anaphylaxis (prevention & control, chemically induced)

PubMed ID

40326871

Recommended Citation

Wang, C., Ramsey, A., Lang, D., Maria Copaescu, A., Krishnan, P., Kuruvilla, M., Mervak, B., Newhouse, J., Sumkin, A., & Saff, R. (2025). Management and Prevention of Hypersensitivity Reactions to Radiocontrast Media: A Consensus Statement from the American College of Radiology and the American Academy of Allergy, Asthma & Immunology. Radiology, 315 (2), e240100. https://doi.org/10.1148/radiol.240100