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Increased incidence of hypersensitivity to iodine‐containing radiographic contrast media after interleukin‐2 administration
Author(s) -
Zukiwski Alexander A.,
David Cynthia L.,
Coan John,
Wallace Sidney,
Gutterman Jordan U.,
Mavligit Giora M.
Publication year - 1990
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19900401)65:7<1521::aid-cncr2820650712>3.0.co;2-y
Subject(s) - medicine , chills , premedication , hypersensitivity reaction , contrast medium , vomiting , delayed hypersensitivity , nausea , iodine , anesthesia , sensitization , rash , concomitant , surgery , radiology , immune system , immunology , materials science , metallurgy
Eight of 28 (28%) cancer patients with liver metastases treated by either splenic (four) or hepatic (four) arterial infusion of recombinant interleukin‐2 (rIL‐2) developed hypersensitivity reactions to iodine‐containing radiographic contrast media. These reactions consisted of fever, chills, malaise, nausea and vomiting, skin rash, diarrhea, and occasionally, hypotension. Reactions usually occurred 1 month after the initial arteriographic procedure and rIL‐2 infusion, with 1‐hour to 4‐hour intervals between procedure and reexposure of the patient to the iodine‐containing contrast medium (used in conjunction with computerized tomography or repeated arteriography for subsequent courses of rIL‐2 infusions) and the onset of symptoms. Prompt administration of corticosteroids during the reaction and premedication of patients who were known to have had a reaction in the past were very effective in stopping reactions or preventing them from reoccurring. The high incidence (28%) of hypersensitivity reactions, the temporal relationship (4 hours) between the arteriographic procedure (utilizing iodine‐containing contrast medium) and the initial infusion of rIL‐2 (while some of the contrast medium was still present), and the absence of such hypersensitivity reactions among patients receiving systemic (intravenous) rIL‐2 (not requiring the use of concomitant iodine‐containing contrast medium) provide additional evidence that in the presence of a potentially immunogenic moiety, rIL‐2, a potent stimulant of the human immune system, can produce an initial sensitization followed by subsequent anamnestic reaction upon reexposure of the patient to the immunogen (even without the additional rIL‐2).