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Tatalaksana seorang pasien dengan kecurigaan alergi makanan mengandung iodine dan memiliki riwayat reaksi hipersensitivitas zat kontras yang menjalani pemeriksaan dengan media kontras berbasis iodine: sebuah laporan kasus

  • Ida Ayu Putu Padmi Deviani ,
  • I Ketut Suardamana ,

Abstract

Background: Radiocontrast agents are some of the most used medications in the emergency department. However, physicians and patients misunderstand the role of allergies in reactions to radiocontrast media, especially regarding shellfish and iodine. A history of prior reaction to contrast increases the risk of mild reactions to as high as 7-17% but has not been shown to increase the rate of severe reactions.

Case Illustration: A 43-year-old female patient was admitted to the hospital with planned coronary angiography. The patient with a history of suspected contrast hypersensitivity 2 months ago when the patient did cardiac CT angiography.  The patient also stated that she has an allergy to eggs, shrimp, shells, nuts, and mackerel tuna. The patient was given premedication with oral 50 mg prednisone at 13 hours and 7 hours before the procedure, and oral 50 mg prednisone plus 50 mg intramuscular diphenhydramine 1 hour before the procedure. Hypersensitivity reaction during admission did not occur.

Conclusion: The management and prophylaxis of contrast allergy include analyzing the history of contrast allergy before and premedication with steroids and antihistamines.

 

Latar Belakang: Agen radiokontras adalah salah satu obat yang paling banyak digunakan di unit gawat darurat. Namun, seringkali dokter dan pasien salah memahami peran alergi terhadap reaksi terhadap media radiokontras, terutama mengenai kerang dan yodium. Riwayat reaksi sebelumnya terhadap kontras meningkatkan risiko reaksi ringan hingga 7-17% namun belum terbukti meningkatkan reaksi berat.

Ilustrasi Kasus: Seorang pasien wanita berusia 43 tahun dirawat di rumah sakit dengan rencana angiografi koroner. Pasien dengan riwayat dugaan hipersensitivitas kontras 2 bulan yang lalu saat pasien dilakukan CT angiografi jantung. Pasien juga menyatakan bahwa dirinya memiliki alergi terhadap telur, udang, kerang, kacang-kacangan, dan ikan tongkol. Pasien diberikan premedikasi dengan prednison 50 mg oral pada 13 jam dan 7 jam sebelum prosedur, dan prednison 50 mg oral ditambah 50 mg difenhidramin intramuskular 1 jam sebelum prosedur. Reaksi hipersensitivitas saat di rumah sakit tidak terjadi.

Kesimpulan: Penatalaksanaan dan profilaksis alergi kontras meliputi analisis riwayat alergi kontras sebelumnya serta premedikasi dengan steroid dan antihistamin.

References

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How to Cite

Deviani, I. A. P. P. ., & Suardamana, I. K. (2023). Tatalaksana seorang pasien dengan kecurigaan alergi makanan mengandung iodine dan memiliki riwayat reaksi hipersensitivitas zat kontras yang menjalani pemeriksaan dengan media kontras berbasis iodine: sebuah laporan kasus. Intisari Sains Medis, 14(3), 1181–1185. https://doi.org/10.15562/ism.v14i3.1866

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Ida Ayu Putu Padmi Deviani
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I Ketut Suardamana
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