Inflachromene

To determine the risk factors associated with immediate hypersensitivity reactions to contrast media (CM-IHR).

A systematic search was conducted in PubMed, Embase, Ovid, Web of Science database and the Cochrane Library up to December 2024 to identify studies in which risk factors associated with CM-IHR were explored. The Newcastle-Ottawa Scale was used to assess the risk of bias. Odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor were pooled from the selected studies. Heterogeneity was evaluated via the Higgins I² test.

From 8,342 citations, seven were ultimately included in the meta-analysis, encompassing a total of 115,043 patients and 736,203 injections. The methodological quality was rated as high in six studies and moderate in one. Four studies investigated iodinated CM (ICM), while 3 investigated gadolinium-based contrast agent. Female sex (OR 1.46; 95 % CI 1.33-1.59) was identified as a significant risk factor for CM-IHR, and age showed an inverse association with risk (OR 0.98; 95 % CI 0.98-0.99). Asthma history was not suggested as a significant risk factor (OR 1.12; 95 % CI, 0.95-1.33; I² = 0 %). For ICM-IHR specifically, outpatient status was associated with higher risk (OR, 3.08; 95 % CI, 1.13-8.44). Notably, pooled analysis of two studies suggested a trend toward increased risk with prior history of hypersensitivity reaction to ICM; however, this association was not statistically significant and was accompanied by high heterogeneity (OR 7.49; 95 % CI, 0.42-135.09, I² = 87 %).

Our systematic review and meta-analysis suggest that female sex was a significant risk factor for CM-IHR, whereas increasing age was associated with a lower risk. Outpatient status showed a significant association with ICM-IHR. Prior history of hypersensitivity reaction to ICM was not identified as a significant risk factor. Given the small number of available studies and substantial heterogeneity, these findings should be interpreted with caution.

Excess iodine intake due to iodinated contrast media (ICM) infusion during medical examinations is considered as a potential cause of thyroid abnormalities. However, the short-term effects of ICM exposure on patients in a Chinese population are not well elucidated.

In total, 200 patients who received intravenous ICM were enrolled, and their thyroid function was determined before ICM exposure (baseline) as well as 1 week and 1 month after the ICM infusion. The relationship between the peak urinary iodine concentration (UIC) and the contrast agent (CA) dose was then investigated. Three months after ICM exposure, the patients who developed thyroid dysfunction within 1 month of ICM exposure were followed up.

This study included 125 males and 75 females, with a mean age of 56.56 ± 13.89 years old and an average CA dose of 26.93 ± 8.35 g. Patients with thyroid nodules had an increased risk of subclinical hyperthyroidism (OR = 2.1491, 95% CI: 1.0335-71.1880, p = 0.0465). Additionally, the urinary iodine level (1658.37 ± 527.47 μg/L) peaked at 1 week after ICM exposure, and the peak level was weakly positively correlated with free thyroxine (FT4) level (r = 0.1531, p = 0.0317). Meanwhile, CA dose weakly negatively correlated with anti-thyroid peroxidase antibody (TPOAb) (r=-0.2077, p = 0.0035). The follow-up results at 3 months after ICM exposure showed that the newly developed abnormal thyroid function within 1 month of ICM exposure had mostly returned to normal.

Patients with thyroid nodules had an increased risk of subclinical hyperthyroidism 1 month after iodine contrast imaging. The effect was transient, and most patients self-recovered without any intervention.