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1 Work Group Mini-Symposium II: S623 , . , , , .1) . , , , , .2,3) 13,552 , .4) , , 1 3% , .5,6) , IgE.

2 , (Table 1). 1950 , 1980 iohexol, iopamidol, ioversol, iodixanol . , .2010 2010 S624 High osmolality contrast mediaLow osmolality contrast mediaOsmolality 600 2,100 mOsm/kg290 860 mOsm/kg600 mOsm/kgThe lowest osmolalityStructureIonic monomerNonionic monomerIonic dimerNonionic dimerProductsDiatrizoate (Renografin , Hypaque )Iothalamate (Conray )Iohexol (Omnipaque )Iopamidol (Isovue )Ioversol (Optiray )Iopromide (Ultravist )Ioxaglate (Hexabrix ) Iodixanol (Visipaque )Table 1.

3 Classification of radiocontrast mediaFig. 1. Classification of adverse reactions to radiocontrast media [Adapted from 1]. (Fig. 1). (Table 2). 1 , , , , , , , , , . 70% , . 70% 5 , , 96% 20 20 .1,2) S625 UrticariaAngioedema/facial edemaAbdominal pain, nausea, diarrheaRhinitisHoarsenessCough, dyspnea, bronchospasm, laryngeal edemaRespiratory arrestHypotension, cardiovascular shockCardiac arrestExanthema (maculopapular drug eruption)Urticaria, angioedemaErythema multiforme minorFixed drug eruptionStevens-Johnson syndromeToxic epidermal necrolysisGraft-versus-host reactionDrug-related eosinophilia with systemic symptoms (DRESS)VasculitisTable 2.

4 Clinical manifestations of immediate and non-immediate hypersensitivity reactions to radiocontrast mediaGradeSymptomsSkinAbdomenRespiratory tractCirculationIPruritusFlushUrticariaA ngioedemaIIPruritusFlushUrticariaAngioed emaNausea, CrampingRhinorrheaHoarseness, DyspneaTachycardia ( 20/min)Hypotension ( 20 mmHg, syst.)ArrhythmiaIII PruritusFlushUrticariaAngioedemaVomiting DefecationDiarrheaLaryngeal edemaBronchospasmCyanosisShockIV PruritusFlushUrticariaAngioedemaVomiting DefecationDiarrheaRespiratory arrestCirculatory arrestTable 3. Severity of immediate hypersensitivity reactions to contrast media7) . Ring Messner 7) (Table 3).

5 10 , (maculopapular rash) , , , . , (DRESS, drug-related eosinophilia with systemic reactions), (Stevens-Johns syndrome), (toxic epidermal necrolysis) 2010 S626 . , , .. , CH50 C3a, C5a , bradykinin , IgE- . , . , IgE- , , , , IgE.

6 , , , IgE IgE- . 2009 , 122 26% , , , 2 6 50% . 32 27 4 , 11 8 .8) , T IgG . , , CD4 , CD8 (CD45RO ) T , CD69 , .9) , IL-2 IL-2 T.

7 37% .8) , CD69, CD25 T- CD4 T skin homing receptors CD8 T- perforin , S627 CD63 .10) , , . IgE , basophil activation test in vitro test . 10 .8) ml.

8 ,8,10-12) 6 .. Lymphocyt transformation test T , CD69 , . , . , , , , , , , , .. 2008 CHRAIAP working group ,13) 2000 .14,15) .8) , , , in vitro tests.

9 , , , 9 (1975 1996, 10,011 ) 2010 S628 , , .16) , (H1R ) . 10% ,1) , , . , .. , , .. (6-methylprednisolone 40 mg) cyclosporine 100 mg 1 2 1 2.

10 17) , TEN .. , , .. 1. Brockow K, Ring J. Classification and pathophysiology of radiocontrast media hypersensitivity. Chem Immunol Allergy 2010;95 Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media . A report from the Japanese Committee on the Safety of Contrast media . Radiology 1990;175:621-8. GL, Arenson RL, Cross AP. A prospective trial of ionic vs nonionic contrast agents in routine clinical practice: comparison of adverse effects.