Contrast media histamine release

Lang J, Lasser EC, Talner LB (1974) Inorganic iodide in contrast media. Invest Radiol 9 51 Lang J, Walters AJ (1970) Are contrast media histamine releasers Invest Radiol 5 277 Lasser EC (1968) Basic mechanisms of contrast media reactions. Theoretical and experimental considerations. Radiology 91 63-65 Lasser EC, Lang J (1966) Inhibition of acetylcholinesterase by some organic contrast media. 

Immediate hypersensitivity reactions to RCM are associated with histamine release from basophils and mast cells [27], and extensive mast cell activation in vivo associated with clinical symptoms has been demonstrated by Earoche et al. [31]. Patients with hypersensitivity reactions after contrast medium exposure had increased plasma levels of both histamine and tryptase, and levels correlated with severity. Also other investigators have reported high levels of tryptase in connection with severe or fatal reactions [21, 33]. 

In humans the allergic reactions from contrast media resemble those elicited by histamine injection, and the unpleasant side effects are rarer after fast injection than after slow injection of the same dose of contrast medium (489). Seidel et al. (724) showed that usual doses of chemically different contrast media were able to affect the plasma histamine levels in venous blood of healthy persons. Histamine release ceases when the dose rate is reduced to 0.17 g kg min This may explain the advantage of administering urographic agents by infusion to avoid reactions. 

From at least the early 1980s, studies relevant to the possibility of monitoring contrast media-induced histamine release either directly or indirectly via measurement of urinary methy Ihistamine have been pursued. Although concentrations of histamine and its metabolite have been shown to increase in some patients who had an adverse reaction to a contrast medium, diagnostic tests for these mediators have not often been used and it was not until an assay for tryptase (see Sect. 4.5.1) became widely available that routine measurement... 

---