Transient refractory period in severe iodinated contrast media allergy: a case report
Bibliographic record
Abstract
BACKGROUND: Hypersensitivity reactions to iodinated contrast media (ICM) are rare but can be life-threatening. Management typically involves avoidance of the offending agent and the use of alternative imaging strategies. The phenomenon of a transient refractory period-wherein a patient does not exhibit an allergic response upon re-exposure to the allergen shortly after an initial reaction-has been proposed but is not well-documented in the context of ICM. CASE PRESENTATION: We report the case of a 56-year-old woman who experienced an anaphylaxis associated cardiac arrest following administration of iopamidol 370 (Niopam 370) during a computed tomography pulmonary angiogram (CTPA). She was resuscitated, intubated, and stabilized with noradrenaline. Two hours later, she underwent a second CT scan using iopamidol 300 (Niopam 300) without any obvious immediate hypersensitivity reaction. Subsequent skin testing was positive for both Niopam 370 and Niopam 300, but negative for alternative agents - iodixanol (Visipaque) and iohexol (Omnipaque). CONCLUSIONS: This case suggests the presence of a transient refractory period following a severe hypersensitivity reaction to ICM, during which re-exposure to the allergen does not elicit an immediate response. Understanding this phenomenon could have significant implications for the management of urgent imaging needs in patients with known ICM hypersensitivity.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".