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1. Immediate Hypersensitivity to Contrast Agents: The French 5-year CIRTACI Study

Author

Olivier Clement, Pascale Dewachter, Claudie Mouton-Faivre, Camille Nevoret, Laurence Guilloux, Evelyne Bloch Morot, Sandrine Katsahian, Dominique Laroche, Martine Audebert, Béatrice Benabes-Jezraoui, Yves Benoit, Sylvie Beot, Frédéric Berard, Yves Berthezene, Philippe Bertrand, Juliette Bouffard, Jean-Luc Bourrain, Bruno Boyer, Marie-France Carette, Christine Caron-Poitreau, Béatrice Cavestri, Jean Pierre Cercueil, Denis-André Charpin, Evelyne Collet, Arielle Crombe-Ternamian, Jacques Dalmas, Eric Decoux, Marie-France Defrance, Yvonne Delaval, Pascal Demoly, Claude Depriester, Pascale Depriester, Alain Didier, Martine Drouet, Benoît Dupas, Dominique Dupre-Goetchebeur, Charles Dzviga, Christine Fabre, Gilbert Ferretti, Corinne Fourre-Jullian, Pascal Girardin, Jacques Giron, Marion Gouitaa, Nicolas Grenier, Lydie Guenard Bilbault, Stéphane Guez, Nathalie Gunera-Saad, Jean-François Heautot, Dominique Herbin, Cyrille Hoarau, Claude Jacquot, Christian Julien, Laurent Laborie, Claude Lambert, Pascal Larroche, Xavier Leclerc, Laurent Lemaitre, Francisque Leynadier, Agnès Lillo-Le-Louet, Jean-Pierre Louvel, Nathalie Louvier, Marie-Madeleine Lucas, Geneviève Meites, Nicolas Mennesson, Liliane Metge, Yannick Meunier, Laurence Monnier-Cholley, Mariano Musacchio, Brigitte Nicolie, Gisèle Occelli, Hélène Oesterle, Francine Paisant-Thouveny, Michel Panuel, Nadine Railhac, Frédérique Rety-Jacob, Cécile Rochefort-Morel, Catherine Roy, Philippe Sarlieve, Musa Sesay, Catherine Sgro, Patrice Taourel, Patrick Terrier, Odile Theissen, Ingrid Topenot, Jocelyne Valfrey, Francis Veillon, Marie-Claude Vergnaud, Charles Veyret, Denis Vincent, Benoit Wallaert, François Wessel, and Marc Zins

Subjects
Medicine (General), R5-920
Abstract

Background: Iodinated and gadolinium-based contrast media (ICM; GBCM) induce immediate hypersensitivity (IH) reactions. Differentiating allergic from non-allergic IH is crucial; allergy contraindicates the culprit agent for life. We studied frequency of allergic IH among ICM or GBCM reactors. Methods: Patients were recruited in 31 hospitals between 2005 and 2009. Clinical symptoms, plasma histamine and tryptase concentrations and skin tests were recorded. Allergic IH was diagnosed by intradermal tests (IDT) with the culprit CM diluted 1:10, “potentially allergic” IH by positive IDT with pure CM, and non-allergic IH by negative IDT. Findings: Among 245 skin-tested patients (ICM = 209; GBCM = 36), allergic IH to ICM was identified in 41 (19.6%) and to GBCM in 10 (27.8%). Skin cross-reactivity was observed in 11 patients with ICM (26.8%) and 5 with GBCM (50%). Allergy frequency increased with clinical severity and histamine and tryptase concentrations (p 50% of life-threatening ones. GBCM and ICM triggered comparable IH reactions in frequency and severity. Cross-reactivity was frequent, especially for GBCM. We propose considering skin testing with pure contrast agent, as it is more sensitive than the usual 1:10 dilution criteria.

Published
2018
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2. Epidemiology of perioperative anaphylaxis in France in 2017–2018: the 11th GERAP survey

Author

Martine, Morisset, Solène, Husser, Vinh An, Huyn, Mélanie, Perquin, Florence, Lakkis-Castelain, Christine, Feesenmeyer, Christelle, Pellerin, Marilyne, Bordes-Demolis, Antoine, Giraudon, Elleni, Vaia, Delphine, Mariotte, Yann, Ollivier, Julien, Serrier, Georgia, Dalampira, Daniela, Muti, Charlotte, Baud, Ferrand, Clermont, Rosita, Capo-Chichi, Sandrine, Seltzer, Sophie, Vandenbergue-Durr, Valentina, Zambelli, Eloïse, Pottier, Amélie, Mear, Guillaume, Pouessel, Alain, Facon, De Chambure Diane, Pelletier, Christine, Delebarre-Sauvage, Juliette, Caron, Elisabeth, Bellet, Isabelle, Orsel, Le Quang, Diane, Christelle, Mullet, Nathalie, Diot-Junique, Rolande, Ferrenq-Dubost, Carine, Billard, Sébastien, Lefervre, Anca, Chiriac, Pascal, Demoly, Marion, Gouitaa, Eva, Serrano, Marie, Tezier, El Hanache, Hassan, Luc, Colas, Emmanuelle, Aguinet, Isabelle, Petit, Gilles, Rezzadori, Minaxi, Patel, Sophie, Miran, Aïcha, Merzouk, Magdalena, Smilov, Aurélie, Gouel-Cheron, Catherine, Neukirch, Chantal, Karila-Beaulier, David, Lepage, Alice, Seringulian, Marion, Verdaguer, Valérie, Renauld, Jean-Marc, Malinovsky, Cécile, Rochefort-Morel, Sabrina, Dessard, Le Guillou, Lisa, Sébastien, Franchina, Yannick, Meunier, Emmanuel, Girard, Samer, Nafeh, Cédric, Delzanno, Charles, Dzviga, Rodolphe, Stenger, Charles, Tacquard, Paul-Michel, Mertes, Le Guen, Morgan, Céline, Gil, Claire, Mailhol, Isabelle, Migueres, Cyrille, Hoarau, Tacquard, Charles, Serrier, Julien, Viville, Simon, Chiriac, Anca-Mirela, Franchina, Sébastien, Gouel-Cheron, Aurélie, Giraudon, Antoine, Malinovsky, Jean-Marc, Petitpain, Nadine, Demoly, Pascal, and Mertes, Paul M.

Published
2024
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3. Epidemiology of perioperative anaphylaxis in France in 2017–2018: the 11th GERAP survey

Author

Tacquard, Charles, primary, Serrier, Julien, additional, Viville, Simon, additional, Chiriac, Anca-Mirela, additional, Franchina, Sébastien, additional, Gouel-Cheron, Aurélie, additional, Giraudon, Antoine, additional, Le Guen, Morgan, additional, Le Quang, Diane, additional, Malinovsky, Jean-Marc, additional, Petitpain, Nadine, additional, Demoly, Pascal, additional, Mertes, Paul M., additional, Martine, Morisset, additional, Solène, Husser, additional, Vinh An, Huyn, additional, Mélanie, Perquin, additional, Florence, Lakkis-Castelain, additional, Christine, Feesenmeyer, additional, Christelle, Pellerin, additional, Marilyne, Bordes-Demolis, additional, Antoine, Giraudon, additional, Elleni, Vaia, additional, Delphine, Mariotte, additional, Yann, Ollivier, additional, Julien, Serrier, additional, Georgia, Dalampira, additional, Daniela, Muti, additional, Charlotte, Baud, additional, Ferrand, Clermont, additional, Rosita, Capo-Chichi, additional, Sandrine, Seltzer, additional, Sophie, Vandenbergue-Durr, additional, Valentina, Zambelli, additional, Eloïse, Pottier, additional, Amélie, Mear, additional, Guillaume, Pouessel, additional, Alain, Facon, additional, De Chambure Diane, Pelletier, additional, Christine, Delebarre-Sauvage, additional, Juliette, Caron, additional, Elisabeth, Bellet, additional, Isabelle, Orsel, additional, Christelle, Mullet, additional, Nathalie, Diot-Junique, additional, Rolande, Ferrenq-Dubost, additional, Carine, Billard, additional, Sébastien, Lefervre, additional, Anca, Chiriac, additional, Pascal, Demoly, additional, Marion, Gouitaa, additional, Eva, Serrano, additional, Marie, Tezier, additional, El Hanache, Hassan, additional, Luc, Colas, additional, Emmanuelle, Aguinet, additional, Isabelle, Petit, additional, Gilles, Rezzadori, additional, Minaxi, Patel, additional, Sophie, Miran, additional, Aïcha, Merzouk, additional, Magdalena, Smilov, additional, Aurélie, Gouel-Cheron, additional, Catherine, Neukirch, additional, Chantal, Karila-Beaulier, additional, David, Lepage, additional, Alice, Seringulian, additional, Marion, Verdaguer, additional, Valérie, Renauld, additional, Jean-Marc, Malinovsky, additional, Cécile, Rochefort-Morel, additional, Sabrina, Dessard, additional, Le Guillou, Lisa, additional, Sébastien, Franchina, additional, Yannick, Meunier, additional, Emmanuel, Girard, additional, Samer, Nafeh, additional, Cédric, Delzanno, additional, Charles, Dzviga, additional, Rodolphe, Stenger, additional, Charles, Tacquard, additional, Paul-Michel, Mertes, additional, Céline, Gil, additional, Claire, Mailhol, additional, Isabelle, Migueres, additional, and Cyrille, Hoarau, additional

Published
2024
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4. Pholcodine exposure increases the risk of perioperative anaphylaxis to neuromuscular blocking agents: the ALPHO case-control study

Author

Paul Michel Mertes, Nadine Petitpain, Charles Tacquard, Marion Delpuech, Cédric Baumann, Jean Marc Malinovsky, Dan Longrois, Aurélie Gouel-Cheron, Diane Le Quang, Pascal Demoly, Jean Louis Guéant, Pierre Gillet, Emmanuelle Aguinet, Pol André Apoil, Jean Eric Autegarden, Faiza Bettayeb, Céline Biermann, Maryline Bordes-demolis, Anca Chiriac, Pierre Antoine Darene, Frédéric Deblay, Sabrina Dessard, Charles Dzviga, Hassan El Hanache, Alain Facon, Yannick Fuhrer, Noémie Gest, Marion Gouitaa, Adela Harpan, Cyrille Hoarau, Lisa Le Guillou, Laurence Lepeltier, Claire Mailhol, Delphine Mariotte, Yannick Meunier, Isabelle Migueres, Martine Morisset, Catherine Neukirch, Dalila Nouar, Yann Ollivier, Isabelle Orsel, Omar Outtas, Minaxi Patel, Christelle Pellerin, Isabelle Petit, Anaïs Pipet, Cécile Rochefort-Morel, Claire Schwartz, Sandrine Seltzer, Alice Seringulian, Angèle Soria, Lilia Soufir, Rodolphe Stenger, Céline Tummino, Marion Verdaguer, Les Hôpitaux Universitaires de Strasbourg (HUS), Biologie et Pharmacologie des Plaquettes sanguines : hémostase, thrombose, transfusion (BPP), Université de Strasbourg (UNISTRA)-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Nouvel Hôpital Civil de Strasbourg, Centre Régional de PharmacoVigilance de Lorraine (CRPV Lorraine), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département Méthodologie Promotion Investigation [CHRU Nancy] (MPI), Centre Hospitalier Universitaire de Reims (CHU Reims), Hémostase et Remodelage Vasculaire Post-Ischémie (HERVI - EA 3801), Université de Reims Champagne-Ardenne (URCA), Service d'anesthésie - réanimation chirurgicale [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Anticorps en thérapie et pathologie - Antibodies in Therapy and Pathology, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre de référence des maladies héréditaires du métabolisme (MaMEA Nancy-Brabois), Service d'Hépato-gastro-entérologie [CHRU Nancy], Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Service de Pharmacologie Clinique et Toxicologie [CHRU Nancy], The ALPHO study NCT02250729 was requested and supported by the European Medicines Agency (EMA). It was funded by a consortium of pharmaceutical companies marketing pholcodine (Zambon, Urgo, Les Laboratoires Pierre Fabre, Boots, Hepatoum, Biocodex, Sanofi, Laboratoires Bouchara Recordati, GlaxoSmithKline, Alliance Pharmaceuticals Ltd, Bells Healthcare, Pinewood, T & R, Ernest Jackson, Vemedia)., and ALPHO Study Group: Emmanuelle Aguinet, Pol André Apoil, Jean Eric Autegarden, Faiza Bettayeb, Céline Biermann, Maryline Bordes-Demolis, Anca Chiriac, Pierre Antoine Darene, Frédéric Deblay, Sabrina Dessard, Charles Dzviga, Hassan El Hanache, Alain Facon, Yannick Fuhrer, Noémie Gest, Marion Gouitaa, Adela Harpan, Cyrille Hoarau, Lisa Le Guillou, Laurence Lepeltier, Claire Mailhol, Delphine Mariotte, Yannick Meunier, Isabelle Migueres, Martine Morisset, Catherine Neukirch, Dalila Nouar, Yann Ollivier, Isabelle Orsel, Omar Outtas, Minaxi Patel, Christelle Pellerin, Isabelle Petit, Anaïs Pipet, Cécile Rochefort-Morel, Claire Schwartz, Sandrine Seltzer, Alice Seringulian, Angèle Soria, Lilia Soufir, Rodolphe Stenger, Céline Tummino, Marion Verdaguer

Subjects
Anesthesiology and Pain Medicine, [SDV]Life Sciences [q-bio], anaphylaxis, anaesthesia, quaternary ammonium compounds, neuromuscular blocking agents, pholcodine
Abstract

International audience; BackgroundNeuromuscular blocking agents (NMBAs) are among the leading cause of perioperative anaphylaxis, and most of these reactions are IgE mediated. Allergic sensitisation induced by environmental exposure to other quaternary ammonium-containing compounds, such as pholcodine, has been suggested. The aim of this study was to assess the relationship between pholcodine exposure and NMBA-related anaphylaxis.MethodsALPHO was a multicentre case-control study, comparing pholcodine exposure within a year before anaesthesia between patients with NMBA-related perioperative anaphylaxis (cases) and control patients with uneventful anaesthesia in France. Each case was matched to two controls by age, sex, type of NMBA, geographic area, and season. Pholcodine exposure was assessed by a self-administered questionnaire and pharmaceutical history retrieved from pharmacy records. The diagnostic values of anti-pholcodine and anti-quaternary ammonium specific IgE (sIgE) were also evaluated.ResultsOverall, 167 cases were matched with 334 controls. NMBA-related anaphylaxis was significantly associated with pholcodine consumption (odds ratio 4.2; 95% confidence interval 2.3–7.0) and occupational exposure to quaternary ammonium compounds (odds ratio 6.1; 95% confidence interval 2.7–13.6), suggesting that apart from pholcodine, other environmental factors can also lead to sensitisation to NMBAs. Pholcodine and quaternary ammonium sIgEs had a high negative predictive value (99.9%) but a very low positive predictive value (

Published
2023

5. Antigen 5–spiked Vespula and Polistes venom extracts for Vespid allergy diagnostics: A French multicenter study

Author

Claude Lambert, M. Drouet, Françoise Bienvenu, P.A. Apoil, Charles Dzviga, Thierry Tabary, D. Mariotte, Séverine Brabant, Laurence Guilloux, François Lavaud, Anne Sarrat, Joana Vitte, Pascale Nicaise-Roland, Joëlle Birnbaum, Céline Beauvillain, Nicolas Hutt, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Service de dermatologie, vénéreologie et cancérologie cutanée [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Nouvel Hôpital Civil de Strasbourg, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'immunologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut d'Immunologie [CHRU Lille], Pôle de Biologie Pathologie Génétique [CHU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Eurofins Biomnis, Laboratoire d'Immunologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire de Reims (CHU Reims), Unité Fonctionnelles d′Immunologie [CHU Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'immunologie et d'immunogénétique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Institut Hospitalier Universitaire Méditerranée Infection (IHU Marseille), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Unité différenciation épidermique et auto-immunité rhumatoïde (UDEAR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)

Subjects
Male, 0301 basic medicine, Allergy, MESH: Immunoglobulin E / blood, Wasps, Wasp Venoms, Venom, Vespula, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, MESH: Aged, 80 and over Allergens / immunology, Immunology and Allergy, MESH: Animals, MESH: Hypersensitivity / immunology, Child, Aged, 80 and over, MESH: Aged, MESH: Immunoglobulin E / immunology, MESH: Middle Aged, biology, Middle Aged, MESH: Infant, MESH: Young Adult, Child, Preschool, Female, France, Polistes, MESH: Wasp Venoms / immunology, MESH: Wasps / immunology, Adult, Pulmonary and Respiratory Medicine, Adolescent, Immunology, Young Adult, 03 medical and health sciences, Antigen, Hypersensitivity, medicine, Animals, Humans, MESH: Hypersensitivity / blood, Aged, MESH: Adolescent, MESH: Hypersensitivity / diagnosis, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, MESH: Adult, Polistes spp, Allergens, Immunoglobulin E, biology.organism_classification, medicine.disease, MESH: Male, MESH: France, 030104 developmental biology, 030228 respiratory system, Multicenter study, business, MESH: Female
Abstract

International audience; Vespula and Polistes spp venom extracts (VEs) for ImmunoCAP (Thermo Fisher Scientific, Uppsala, Sweden) platforms have beenspiked, that is, enriched, with group 5 allergens since 2012. Limited information was available from the manufacturer, but small cohortshave reported altered performance for in vitro diagnostics.1,2 Herein we present the results of a French multicenter study onantigen 5–spiked Vespula and Polistes VEs compared with nonspiked VEs

Published
2018

6. Human peripheral basophils extended phenotype shows a high expression of CD244 immuno-regulatory receptor

Author

Coralie Durrieu, Claude Lambert, Charles Dzviga, Anne-Emmanuelle Berger, and Jean-Luc Perrot

Subjects
Adult, Male, 0301 basic medicine, CD32, CD3, Immunology, chemical and pharmacologic phenomena, Basophil, Immunoglobulin E, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Signaling Lymphocytic Activation Molecule Family, parasitic diseases, medicine, Humans, Immunology and Allergy, Receptor, Aged, Aged, 80 and over, CD64, biology, hemic and immune systems, Middle Aged, Healthy Volunteers, Basophils, Basophil activation, 030104 developmental biology, medicine.anatomical_structure, biology.protein, Female, Antibody, 030215 immunology
Abstract

Introduction Basophils play a major physio-pathological role in hypersensitivity related diseases. Basophils express high affinity Immunoglobulin (Ig) E receptors (FceRI), IgG and complement regulatory. Basophils also have immunoregulatory activity through interaction with T cells. The aim of this study was to look for the expression of markers reflecting the activation status of peripheral Basophil in healthy donors. Method the study was performed on 29 healthy donors, 62% females with a mean age of 50.1 + 17.0 years. Basophils were identified on their expression of CD123 without HLA-DR and/or CD193 in two 8 colors panels including CD46, CD55, CD59, CD203c, CD32 (FcγRII), CD64 (FcγRIII), CD163, CD137L (4-1BBL), CD252 (OX40L), CD244 (2B4) and CD3 on whole blood. Basophil activation with anti IgE was performed on 14 donors. Results and discussion Our results confirmed the Basophil expression of CD123, CD193 and CD203 (the latter is strongly increased under stimulation). Complement regulatory proteins (CD46, CD55, CD59) were expressed at the same levels as on other leukocytes; CD46, CD59 expression being slightly increased under stimulation. CD32 and CD163 scavenger were slightly higher than on lympho and not influenced by activation. CD252 or CD137L were expressed at low levels and significantly induced by stimulation. Most of all, CD244 was highly expressed on Basophils as compared to any other leukocytes in fresh peripheral blood. Conclusions Our study shows that human resting Basophils express IgE and IgG Fc receptors and check point receptor CD244 that could potentially play a role in their previously reported immunoregulatory activity in sensitization and even in tumor immune escape.

Published
2021

7. Survey on practice of venom immunotherapy in France

Author

Bruno Girodet, Claude Lambert, Joëlle Birnbaum, François Lavaud, Catherine Matevi, Charles Dzviga, and Philippe Bonniaud

Subjects
Protocol (science), 030201 allergy, medicine.medical_specialty, business.industry, Alternative medicine, MEDLINE, General Medicine, Venom immunotherapy, Bioinformatics, medicine.disease, Event management, 03 medical and health sciences, 0302 clinical medicine, 030228 respiratory system, practice survey, medicine, Premedication, Public Health, immunotherapy, Intensive care medicine, business, Late Relapse, venom allergy, Anaphylaxis
Abstract

INTRODUCTION Venom immunotherapy (VIT) is the only efficient prevention for sting-induced anaphylaxis, but its application is not without risks and needs precautions and standardization. European guidelines were proposed in 2005, but recent practice surveys and more recent knowledge raise the need for an update. The aim of this study was to analyze VIT practices in France, based on previous surveys in Europe but also extended to outcome event management. MATERIAL AND METHODS A paper questionnaire was sent widely to persons involved in venom treatment. RESULTS Eighty-six responses could be included from physicians actively involved in VIT induction evenly distributed in France. The survey shows that VIT was engaged from grade III down to grade I reactions, starting preferentially with the ultra-rush protocol. Premedication was used by 42% only and risks induced by co-treatment with β-blockers were well known but not with angiotensin-converting enzyme inhibitors. However, side effects were very variably managed from arrest to enhancement in doses, time-delay or duration. Similarly, we observed a large discrepancy in treatment evaluation (skin tests, biology, timing and interpretation), decision making for treatment termination (when and how long to be prolonged) and post-treatment follow-up (adrenaline kit, event record) as well as procedures in case of late relapse (new induction, different doses). CONCLUSIONS Our study shows that most recommendations were fully or partially followed and may need reminding, but many points need to be completed or updated with new tools and knowledge acquired during the last 10 years.

Published
2016

8. Immediate Hypersensitivity to Contrast Agents: The French 5-year CIRTACI Study

Author

Dominique Herbin, Jacques Dalmas, Frédéric Berard, Jean-Luc Bourrain, Laurence Monnier-Cholley, Laurent Lemaitre, P. Girardin, Agnès Lillo-Le-Louet, Christian Julien, Lydie Guenard Bilbault, François Wessel, Jean Pierre Cercueil, Charles Veyret, Yvonne Delaval, Hélène Oesterle, Liliane Metge, Sylvie Beot, Béatrice Cavestri, Laurent Laborie, Philippe Bertrand, Arielle Crombe-Ternamian, Evelyne Collet, Evelyne Bloch Morot, Nicolas Mennesson, Claude Jacquot, Francis Veillon, Ingrid Topenot, Christine Caron-Poitreau, Brigitte Nicolie, Olivier Clément, Marie-Madeleine Lucas, Martine Audebert, Christine Fabre, Musa Sesay, Jacques Giron, Frédérique Rety-Jacob, Geneviève Meites, Francisque Leynadier, Xavier Leclerc, Pascal Larroche, Catherine Sgro, Claude Depriester, Alain Didier, Laurence Guilloux, Francine Paisant-Thouveny, Gisèle Occelli, Philippe Sarlieve, Sandrine Katsahian, Juliette Bouffard, Stéphane Guez, D. Laroche, Jean-Pierre Louvel, Corinne Fourre-Jullian, Claude Lambert, Yves Berthezene, Denis Vincent, Nicolas Grenier, Charles Dzviga, Cécile Rochefort-Morel, Yannick Meunier, Marie-France Defrance, Odile Theissen, Pascal Demoly, Michel Panuel, Eric Decoux, Cyrille Hoarau, Béatrice Benabes-Jezraoui, Marie-France Carette, Mariano Musacchio, Jean-François Heautot, Benoît Dupas, Benoit Wallaert, Denis-André Charpin, Gilbert Ferretti, Camille Nevoret, Pascale Dewachter, Marion Gouitaa, Patrice Taourel, Pascale Depriester, Yves Benoit, Bruno Boyer, Jocelyne Valfrey, Nadine Railhac, Martine Drouet, Nathalie Louvier, Claudie Mouton-Faivre, Catherine Roy, Marie-Claude Vergnaud, Nathalie Gunera-Saad, Marc Zins, Patrick Terrier, Dominique Dupre-Goetchebeur, Service de Radiologie [CHU HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Biomnis Laboratory, Service de Médecine Interne [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Centre de référence des syndromes drépanocytaires majeurs, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Amiens-Picardie, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'immunologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hôpital de la Croix-Rousse [CHU - HCL], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Grenoble, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Service de dermatologie et allergologie [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital Albert Calmette, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de radiologie et d'Imagerie médicale diagnostique et thérapeutique (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Nord [CHU - APHM], Service de Dermatologie (CHU de Dijon), CH Martigues, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pontchaillou [Rennes], Université de Montpellier (UM), Service de pneumologie [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Morvan - CHRU de Brest (CHU - BREST ), Service de radiologie [Saint-Etienne], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service central de radiologie et d'imagerie médicale, CHU Grenoble-Hôpital Michallon, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital Purpan [Toulouse], Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], Centre Hospitalier Public du Cotentin (CHPC), Service de néphrologie et immunologie clinique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT), Clinique de réanimation médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, CHU Saint-Etienne, Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Services de neuroradiologie [Lille], Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Claude Huriez [Lille], CHU Lille, Service de Radiologie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Hôpital de Rangueil, Service de réanimation médicale [CHU Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Radiologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Hôpital pasteur [Colmar], Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Strasbourg, Laboratoire de Pharmacologie-Toxicologie [CHU de Dijon], Service de pneumologie, allergologie, mucoviscidose pédiatrique [Rouen], Service de radiologie [Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service de Médecine générale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de pneumologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe hospitalier Paris Saint-Joseph - Hôpital, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Service de radiologie et imagerie médicale [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Public du Cotentin [Cherbourg-Octeville] (CHPC), Service de Néphrologie et d’Immunologie Clinique [CHRU Tours], Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Hôpital Jean Minjoz, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Herrada, Anthony, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM), Institut des Neurosciences de Montpellier (INM), CH Centre Hospitalier Public du Cotentin (CHPC), Hôpital Charles Nicolle [Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Centre de référence des syndromes drépanocytaires majeurs-Hôpital Européen Georges Pompidou [APHP] (HEGP), Service de néphrologie et immunologie clinique [CHRU Tours] (EA4245 UT), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours

Subjects
medicine.medical_specialty, Allergy, Tryptase, Gastroenterology, Culprit, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, medicine, Clinical severity, lcsh:R5-920, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, biology, business.industry, General Medicine, medicine.disease, 3. Good health, 030228 respiratory system, chemistry, biology.protein, Intradermal test, Plasma histamine, lcsh:Medicine (General), business, Histamine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Research Paper
Abstract

International audience; Background:Iodinated and gadolinium-based contrast media (ICM; GBCM) induce immediate hypersensitivity (IH) reactions. Differentiating allergic from non-allergic IH is crucial; allergy contraindicates the culprit agent for life. We studied frequency of allergic IH among ICM or GBCM reactors.Methods:Patients were recruited in 31 hospitals between 2005 and 2009. Clinical symptoms, plasma histamine and tryptase concentrations and skin tests were recorded. Allergic IH was diagnosed by intradermal tests (IDT) with the culprit CM diluted 1:10, "potentially allergic" IH by positive IDT with pure CM, and non-allergic IH by negative IDT.Findings:Among 245 skin-tested patients (ICM = 209; GBCM = 36), allergic IH to ICM was identified in 41 (19.6%) and to GBCM in 10 (27.8%). Skin cross-reactivity was observed in 11 patients with ICM (26.8%) and 5 with GBCM (50%). Allergy frequency increased with clinical severity and histamine and tryptase concentrations (p 50% of life-threatening ones. GBCM and ICM triggered comparable IH reactions in frequency and severity. Cross-reactivity was frequent, especially for GBCM. We propose considering skin testing with pure contrast agent, as it is more sensitive than the usual 1:10 dilution criteria.

Published
2018

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