非イオン性造影剤による遅発性副作用の1例

DELAYED REACTIONS TO NON-IONIC CONTRAST MEDIUM AND THE MECHANISM:CONSIDERATION OF A CASE

　イオヘキソール投与後3日後に発熱と倦怠感を伴った全身性の発疹を特徴とする遅発性副作用が出現した症例を経験した．皮内反応と貼布試験の結果から，この副作用の原因はヨードそのものではなく，抗原性を有する非イオン性造影剤の側鎖に対するアレルギー反応と思われた．イオパミドールとの間に交叉感作が成立する場合があり，またこの副作用は感作により早期に出現するようになる可能性がある．

A 79-year-old man developed systemic erythema, fever and general fatigue three days after an intra-venous urography and CT using Iohexol. These symptoms disappeared by administration of corticosteroid. Another erythema developed immediately after urethrography using Iopamidol. The results of a skin test and patch test using several contrast media suggested that the adverse effects were not caused by iodine but by an antigenicity of another side chain of these contrast media. It was also suggested that there would be cross immunization between Iohexol and Iopamidol. A type 4 allergic mechanism must have played a role in this patient.