{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T21:44:55Z","timestamp":1776721495886,"version":"3.51.2"},"reference-count":72,"publisher":"Colegio Mexicano de Inmunologia Clinica y Alergia, A. C.","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Alerg Mex"],"abstract":"<jats:p>ANTECEDENTES: Las reacciones de hipersensibilidad a medios de contraste yodados representan un problema cl\u00ednico relevante debido al uso creciente para estudios radiodiagn\u00f3sticos. Estas reacciones se clasifican en inmunol\u00f3gicas inmediatas, no inmediatas y no inmunol\u00f3gicas, con una prevalencia variable y potenciales consecuencias graves (anafilaxia o reacciones adversas cut\u00e1neas graves). La identificaci\u00f3n de factores de riesgo, clasificaci\u00f3n y mecanismos inmunol\u00f3gicos de los medios de contraste permiten establecer estrategias de prevenci\u00f3n y tratamiento.\nOBJETIVO: Analizar las caracter\u00edsticas qu\u00edmicas de los medios de contraste, mecanismos inmunol\u00f3gicos y m\u00e9todos diagn\u00f3sticos disponibles, con la finalidad de establecer estrategias efectivas para su prevenci\u00f3n, diagn\u00f3stico y tratamiento en poblaciones generales y vulnerables.\nM\u00c9TODOLOG\u00cdA: Se efectu\u00f3 una revisi\u00f3n bibliogr\u00e1fica donde se analizaron los diferentes tipos de medios de contraste, seg\u00fan su estructura qu\u00edmica, osmolaridad, osmolalidad y viscosidad, destacando su asociaci\u00f3n con el riesgo de reacciones de hipersensibilidad. Se describen los mecanismos inmunol\u00f3gicos implicados, incluyendo respuestas mediadas por IgE, c\u00e9lulas T y el receptor MRGPRX2. Se detallan m\u00e9todos diagn\u00f3sticos: estudios in vivo e in vitro, y prueba de exposici\u00f3n controlada, evaluando la sensibilidad, especificidad y utilidad cl\u00ednica. Se puntualiza la reactividad cruzada entre medios de contraste y la utilidad de agruparlos seg\u00fan sus caracter\u00edsticas qu\u00edmicas para elegir alternativas seguras. Finalmente, se abordan estrategias terap\u00e9uticas y preventivas, como la premedicaci\u00f3n, la selecci\u00f3n del medio de contraste y las consideraciones especiales en poblaciones vulnerables (pacientes pedi\u00e1tricos, mujeres embarazadas y adultos mayores).\nCONCLUSIONES: La hipersensibilidad a medios de contraste requiere un enfoque diagn\u00f3stico y terap\u00e9utico multidisciplinario, basado en la adecuada caracterizaci\u00f3n de la reacci\u00f3n, estudios inmunol\u00f3gicos y selecci\u00f3n personalizada del medio de contraste que de administrar\u00e1. El conocimiento actual permite reducir significativamente la recurrencia de reacciones de hipersensibilidad mediante la sustituci\u00f3n del agente implicado y\/o premedicaci\u00f3n, optimizando as\u00ed la seguridad de los procedimientos diagn\u00f3sticos asociados con medios de contraste.\nPALABRAS CLAVE: Medios de contraste yodados; Anafilaxia; Prevalencia; Factores de riesgo; Poblaciones vulnerables; Osmolaridad; IgE; C\u00e9lulas T; Prueba in vitro; Pacientes pedi\u00e1tricos; Mujeres embarazadas; Hipersensibilidad; Premedicaci\u00f3n.<\/jats:p>","DOI":"10.29262\/ram.v73i1.1540","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:41:23Z","timestamp":1774924883000},"page":"76-92","source":"Crossref","is-referenced-by-count":0,"title":["Hipersensibilidad a medios de contraste yodado: estrategias diagn\u00f3sticas y terap\u00e9uticas. Posicionamiento del Comit\u00e9 de Alergia a Medicamentos de Colegio Mexicano de Inmunolog\u00eda Cl\u00ednica y Alergia","Hypersensitivity to iodinated contrast media: Diagnostic and therapeutic strategies. Position Statement of the Drug Allergy Committee of the Mexican College of Clinical Immunology and Allergy"],"prefix":"10.29262","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6023-6934","authenticated-orcid":false,"given":"Rosalaura Virginia","family":"Villarreal Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Universidad Aut\u00f3noma de Nuevo Le\u00f3n, Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez\u201d, Servicio de Oncolog\u00eda, Centro Universitario Contra el C\u00e1ncer. Facultad de Medicina, Monterrey, Nuevo Le\u00f3n, M\u00e9xico."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1922-6917","authenticated-orcid":false,"given":"Nataly Anais","family":"Flores Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Alergia e inmunolog\u00eda Cl\u00ednica Hospital Regional \u201cDr. Valent\u00edn G\u00f3mez Far\u00edas\u201d, ISSSTE, Zapopan, Jalisco"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4977-0618","authenticated-orcid":false,"given":"Leslie Astrid","family":"De la Fuente","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de Nuevo Le\u00f3n, Hospital Universitario \u201cDr. Jos\u00e9 Eleuterio Gonz\u00e1lez\u201d, Servicio de Oncolog\u00eda, Centro Universitario Contra el C\u00e1ncer. 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Hsieh C, Wu SC, Kosik RO, Huang YC, Chan WP. Pharmacological Prevention of Hypersensitivity Reactions Caused by Iodinated Contrast Media: A Systematic Review and Meta-Analysis. Diagnostics. 2022; 12 (7). doi:10.3390\/diagnostics12071673","DOI":"10.3390\/diagnostics12071673"},{"key":"66811","doi-asserted-by":"crossref","unstructured":"2. Bianchi L, Hansel K, Biondi F, et al. Delayed hypersensitivity reactions to iodinated contrast media: A diagnostic approach by skin tests. Contact Dermatitis. 2023; 89 (5): 352-358. doi:10.1111\/cod.14372","DOI":"10.1111\/cod.14372"},{"key":"66812","doi-asserted-by":"crossref","unstructured":"3. Iordache AM, Docea AO, Buga AM, et al. The incidence of skin lesions in contrast media-induced chemical hypersensitivity. Exp Ther Med. 2019; 17 (2): 1113-1124. doi:10.3892\/etm.2018.7056","DOI":"10.3892\/etm.2018.7056"},{"key":"66813","doi-asserted-by":"crossref","unstructured":"4. Rosado Ingelmo A, Do\u00f1a Diaz I, Caba\u00f1as Moreno R, et al. Clinical Practice Guidelines for Diagnosis and Management of Hypersensitivity Reactions to Contrast Media. J Investig Allergol Clin Immunol. 2016; 26 (3): 144-155. doi:10.18176\/jiaci.0058","DOI":"10.18176\/jiaci.0058"},{"key":"66814","doi-asserted-by":"crossref","unstructured":"5. Chatani R, Kondo S, Kamimura T, et al. Exploring Factors Affecting the Occurrence of Hypersensitivity Reactions Induced by Nonionic Iodine Contrast Media. The Journal of Clinical Pharmacology. 2023; 63 (9): 1002-1008. doi:10.1002\/jcph.2256","DOI":"10.1002\/jcph.2256"},{"key":"66815","doi-asserted-by":"crossref","unstructured":"6. Lin X, Yang J, Weng L, Lin W. Differences in Hypersensitivity Reactions to Iodinated Contrast Media: Analysis of the US Food and Drug Administration Adverse Event Reporting System Database. J Allergy Clin Immunol Pract. 2023; 11 (5): 1494-1502.e6. doi:10.1016\/j.jaip.2023.01.027","DOI":"10.1016\/j.jaip.2023.01.027"},{"key":"66816","doi-asserted-by":"crossref","unstructured":"7. Vega F, van de Ven AAJM, van der Molen AJ. Cross-reactivity in hypersensitivity reactions to contrast agents: new classification and guide for clinical practice. Eur Radiol. 2024; 34 (12): 7583-7588. doi:10.1007\/s00330-024-10872-8","DOI":"10.1007\/s00330-024-10872-8"},{"key":"66817","doi-asserted-by":"crossref","unstructured":"8. Gracia Bara MT, Gallardo-Higueras A, Moreno EM, et al. Hypersensitivity to Gadolinium-Based Contrast Media. Frontiers in Allergy. 2022; 3. doi:10.3389\/falgy.2022.813927","DOI":"10.3389\/falgy.2022.813927"},{"key":"66818","doi-asserted-by":"crossref","unstructured":"9. Byrne A, Macdonald DB, Kirkpatrick IDC, et al. CAR\/CSACI Practice Guidance for Contrast Media Hypersensitivity. Canadian Association of Radiologists Journal. doi:10.1177\/08465371241311253","DOI":"10.1177\/08465371241311253"},{"key":"66819","doi-asserted-by":"crossref","unstructured":"10. Lee S, Kang D, Kim J, et al. 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