{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:01:11Z","timestamp":1793228471054,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Allergy Asthma Clin Immunol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The use of in vivo and ex vivo diagnostic tools for delayed hypersensitivity reactions (DHRs) associated with iodinated contrast media (ICM) is currently ill-defined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To evaluate the role of in vivo and ex vivo diagnostic tools for DHRs occurring &gt;6\u00a0h following intravenous low-osmolality ICM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a prospective, multicenter, international cohort study. The patients were recruited from two tertiary care adult allergy clinics, Austin Health, Australia and the McGill University Health Centre, Canada. Eligible participants were adults who reported a DHR after receiving ICM. In vivo testing (skin testing and intravenous challenge) was performed to identify an alternative agent. Ex vivo testing using interferon-\u03b3 enzyme-linked ImmunoSpot assay was performed in four Australian patients to explore its diagnostic performance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The culprit ICM was identified by dIDT in 17\/20 (85%) while in 3\/20 (15%) a challenge was necessary to confirm delayed hypersensitivity. All patients with a positive dIDT to iohexol were positive to iodixanol (15\/15; 100%) while 3\/4 (75%), 3\/4 (75%), 4\/6 (67%), and 3\/5 (60%) were positive to iopromide, ioversol, iopamidol, and iobitridol, respectively. Overall, 7\/20 (35%) patients tolerated a challenge with an alternative ICM. The IFN-\u03b3 release assay was negative for the implicated ICM in 4 patients with confirmed DHR through a positive dIDT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>dIDT allowed confirmation of T cell-mediated allergy to the implicated ICM in 85% of patients with a strong clinical suspicion of DHR and identification of non-cross-reactive ICM in 35% of patients. The IFN-y ELISpot was not useful in the four patients tested.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13223-025-00982-3","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T06:12:14Z","timestamp":1755151934000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The role of skin testing, drug challenge and IFN-\u03b3 ELISpot in delayed hypersensitivity to iodinated contrast media"],"prefix":"10.1186","volume":"21","author":[{"given":"Ana Maria","family":"Copaescu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyra Y. 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Late elicitation of maculopapular exanthemas to iodinated contrast media after first exposure. Ann Allergy Asthma Immunol. 2013;111(6):576\u20137.","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"1","key":"982_CR2","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s00330-002-1650-5","volume":"13","author":"JA Webb","year":"2003","unstructured":"Webb JA, Stacul F, Thomsen HS, Morcos SK, Members of the Contrast Media Safety Committee of the European Society of Urogenital R. Late adverse reactions to intravascular iodinated contrast media. Eur Radiol. 2003;13(1):181\u20134.","journal-title":"Eur Radiol"},{"issue":"5","key":"982_CR3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.23822\/EurAnnACI.1764-1489.129","volume":"52","author":"E Meucci","year":"2020","unstructured":"Meucci E, Radice A, Fassio F, et al. Diagnostic approach to hypersensitivity reactions to iodinated contrast media: a single-center experience on 98 patients. 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Ethical approval was obtained from the respective institutional review boards\u00a0(Canada- MP-37-2022-8458\/IDEAL and Australia\u2014HREC\/15\/AUSTIN\/75 and HREC\/50791\/Austin-19). Informed consent was obtained from all participants prior to testing. The study adhered to the principles of the Declaration of Helsinki and followed institutional and national ethical standards. The participant\u2019s confidentiality and privacy were protected in compliance with ethical regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}