2Cardiology Department, Bourguiba University Hospital, Faculty of Medicine of Monastir, Monastir, Tunisia
3Pathology Department, Bourguiba University Hospital, Faculty of Medicine of Monastir, Monastir, Tunisia
Key-words: Drug eruptions; Acute Generalized Exanthematous Pustulosis(AGEP); Contrast Medias; Iopromide
Author |
Year of publication |
Age of the patient (Year) |
Sex |
Medical history |
Time to onset (Hours) |
Histopathology |
EuroSCAR |
Iodinated Contrast Media |
Patch tests |
Atasoy M, et al. [1] |
2003 |
52 |
F |
Abdominal pain |
72 |
Subcorneal blisters including neutrophils and eosinophils, mildspongiosis, and a sparse infiltrate of neutrophils and eosinophils in the papillary dermis
|
11 |
Iohexol |
Not done |
Belgodere X, et al. [6] |
2004 |
40 |
M |
Subarachnoid hemorrhage Testicular tumor |
20 |
Subcornealblisters including neutrophis and a sparse infiltrate of neutrophils in the papillarydermis
|
10 |
Iopamidol |
Not done |
Peterson A, et al. [13] |
2006
2006 |
Case 1 : 44
Case2 : 30 |
F
F |
Gastric bypass surgery
Hodgkin disease
Chest pressures Paresthesias
|
3 Episodes : 60 ; 14 ; 6
48 |
Subcorneal pustules, rare single apoptotic keratinocytes, and perivascular and interstitial lymphocytes with scattered eosinophils and neutrophils.
Not done |
9
6 |
Iodixanol
Iodixanol |
Not done
Not done |
Hammerbeck AA, et al. [7] |
2009 |
84 |
M |
Bladder cancer Hypertension Parkinson disease Diabetes mellitus Hyperlipidemia Coronary artery disease Benign prostatic hypertrophy Right-sided hydronephrosis Chronic renal insufficiency
|
2 Episodes: 24, 24 |
Subcorneal pustules, epidermal edema and superficial neutrophilic infiltrate with eosinophils |
8 For the two épisodes |
Ioversol for the 2 épisodes |
Not done |
Paquet P, et al. [12] |
2009 |
80 |
M |
B-cell chronic lymphocytic leukemia |
Few hours |
Subcorneal pustules and perivascular and interstitial lymphocytes with scattered eosinophils and neutrophils in the papillary dermis
|
11 |
Iobitridol |
Not done |
Kim SJ, et al. [10] |
2010 |
27 |
M |
Chronic renal failure due to IgA nephropathy 2 Kidney transplant operations *Chronic allograft nephropathy Hemodialysis 3 times a week through a left arterio-venous fistula.
|
6 |
Not done |
8 |
Ioversol |
Not done |
Poliak N, et al. [11] |
2010 |
4 |
M |
Tetralogy of Fallot |
3 Episodes:48H, 42H, 6H30min |
Subcorneal intraepidermal pustules, spongiosis, rare Apoptotic keratinocytes, papillary dermis edema, inflammatory infiltrates, and few eosinophils, |
11 |
Ioversol |
Ioversol + Iohexol + Iothalamate - |
Grandvuillemin A, et al. [9] |
2014 |
Case1 : 45
Case 2 : 26
Case3 ; 79
Case4 : 24
|
F
F
F
M |
allergic rhinitis, Migraine ,cerebral arterial embolization
Asthma, migraine
Osteoarthritis, primary amyloidosis, tramadol-induced urticaria
Aneurysm rupture |
72
24
48
24 |
Subcorneal pustulosis with neutrophils infiltration
Idem
Idem
Idem |
Not evaluated
Idem
Idem
Idem |
Iodixanol
Iomeprol
Iobitridol
Iodixanol |
Iodixanol+ ioxaglate-iomeprol- Iopamidol-iohexol- iobitridol-
Iodixanol- ioxaglate-iomeprol+ Iopamidol-iohexol- iobitridol-
Iodixanol- ioxaglate-iomeprol- Iopamidol-iohexol- iobitridol+/ -
Iodixanol+ ioxaglate-iomeprol- Iopamidol-iohexol- iobitridol- |
Bavbek S, et al. [8] |
2014 |
52 |
F |
Non-ST elevation Myocardial infarction |
3-4 |
Epidermal acanthosis with multifocal pustule formation in the upper part of the epidermis, with inflammation and mild edema in the papillary dermis
|
10 |
Iopromide |
Iodixanol+ iomeprol+ diatrizoate–iopamidol+ iopromide + |
Our case |
2015 |
49 |
M |
Coronary heart disease Psoriasis |
72 |
Spongiform subcorneal pustules and focal necrosis of keratinocytes. An oedema and a perivascular infiltrates with neutrophils and exocytosis of some eosinophils and lymphocytes in the papillary dermis
|
10 |
Iopromide |
Not done |
- Atasoy M, Erdem T, Sari RA. A case of Acute Generalized Exanthematous Pustulosis (AGEP) possibly induced by iohexol. J Dermatol. 2003;30(10):723-6.
- Sidoroff A, Halevy S, Bavinck JN, Vallant L, Roujeau JC. Acute Generalized Exanthematous Pustulosis (AGEP): a clinical reaction pattern. J Cutan Pathol. 2001;28(3):113-9.
- Beylot C, Bioulac P, Doutre MS. [Acute generalized exanthematic pustuloses (four cases) (author's transl)]. Ann Dermatol Venereol. 1980;107(1-2):37-48.
- Speeckaert MM, Speeckaert R, Lambert J, Brochez L. Acute generalized exanthematous pustulosis: an overview of the clinical, immunological and diagnostic concepts. Eur J Dermatol. 2010;20(4):425-33. doi: 10.1684/ejd.2010.0932.
- Brockow K, Romano A, Aberer W, Bircher AJ, Barbaud A, Bonadonna P, Faria E, Kanny G, Lerch M, Pichler WJ, Ring J, Rodrigues Cernadas J, Tomaz E, Demoly P, Christiansen C. European Network of Drug Allergy and the EAACI interest group on drug hypersensitivity. Skin testing in patients with hypersensitivity reactions to iodinated contrast media - a European multicenter study. Allergy. 2009;64(2):234-41. doi: 10.1111/j.1398-9995.2008.01832.x.
- Belgodère X, Wolkenstein P, Pastor MJ. Acute generalized exanthematous pustulosis induced by iopamidol. Ann DermatolVenereol 2004;131:831-2.
- Hammerbeck AA, Daniels NH, Callen JP. Ioversol-induced acute generalized exanthematous pustulosis: a case report. Arch Dermatol.2009;145(6):683-7.doi: 10.1001/archdermatol.2009.100.
- Bavbek S, Sözener ZC, Aydin O, Ozdemir SK, Gül U, Heper AO. First case report of acute generalized exanthematous pustulosis due to intravenous iopromide. J Investig Allergol Clin Immunol. 2014;24(1):66-7.
- Grandvuillemin A, Ripert C, Sgro C, Collet E. Iodinated contrast media-induced acute generalized exanthematous pustulosis confirmed by delayed skin tests. J Allergy Clin Immunol Pract. 2014; 2(6):805-6. doi: 10.1016/j.jaip.2014.07.015.
- Kim SJ, Lee T, Lee YS, Bae YJ, Cho YS, Moon HB, Kim TB. Acute generalized exanthematous pustulosis caused by radio contrast media. Ann Allergy Asthma Immunol. 2010;105(6):492-3. doi: 10.1016/j.anai.2010.10.005.
- Poliak N, Elias M, Cianferoni A, Treat J. Acute generalized exanthematous pustulosis: the first pediatric case caused by a contrast agent. Ann Allergy Asthma Immunol. 2010;105(3):242-3. doi: 10.1016/j.anai.2010.06.018.
- Paquet P, Vandenbossche G, Nikkels AF, Henry F, Piérard GE. Case of the month. Acute generalized exanthematous pustulosis due to an iodinated contrast radiodiagnostic agent. Rev Med Liege 2009;64(12):601-5.
- Peterson A, Katzberg RW, Fung MA, Wootton-Gorges SL, Dager W. Acute generalized exanthematous pustulosis as a delayed dermatotoxic reaction to IV-administered non ionic contrast media. AJR Am J Roentgenol 2006;187(2):W198-201.