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2001; Vavricka et al. 2002). A number of pathophysiological mechanisms have been proposed for late skin reactions. e. they are T-cell mediated (Brockow et al. 2005; Christiansen et al. 2000; Christiansen 2002). The skin reactions often show typical features of late hypersensitivity including exanthematous rash, positive skin tests and lymphocyte rich dermal perivascular infiltrate sometimes accompanied by eosinophils on skin biopsy. F. Stacul 28 If there is doubt about whether contrast medium is responsible for the skin reaction, skin testing (patch and delayed intradermal tests) may be attempted (Akiyama et al.

1992). 6 Prophylaxis In view of the infrequent and self-limiting nature of the great majority of late reactions, it does not seem appropriate to warn patients with no special risk factors about the possibility of a late reaction. However, it is recommended that patients who have had a previous late skin reaction after contrast medium administration who suffer from major drug or contact allergy or who have received interleukin-2 are warned about the possibility of a late skin reaction and told to contact a doctor if they have a problem.

1995). 5 mg/dl), the incidence of contrast medium induced nephropathy was less than 1%. The long-term effects of contrast media on renal function in man are not known. 4 Renal Handling of Contrast Media After intravascular administration contrast medium molecules move across capillary membranes (except an intact blood–brain barrier) into the interstitial, extracellular space. Reverse movement from the extracellular space into the intravascular compartment occurs and a state of equilibrium is generally reached within 2 h.

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