Allergy to iodine

Allergy to iodine is a type of drug intolerance and is not a common disease. Toxic effect of iodine is most often associated with an overdose of iodine-containing drugs, with the presence of chronic diseases of internal organs and systems, less often with individual idiosyncrasy.

The excess of iodine is dangerous, enough 3 grams to provoke cardiac and renal failure, however it is rather difficult for such reasons:

1. The danger is only a pure element of iodine, which is practically impossible outside laboratory conditions, that is, in everyday life. With food or medicine, a fairly harmless form of iodine - inorganic salts or iodides - enters the human body.
2. With a small overdose, after a day the concentration of iodides in the blood comes back to normal, as iodine is quickly absorbed by the thyroid gland and is excreted through the urinary system.
3. In order to get into the body a deadly dose of pure iodine (3-5 grams) you need to eat a few kilograms of sea kale, or, as the proverb says, a pood of salt, but only iodized, which is hardly possible for a person with normal food preferences.
4. Residents of the country of the rising sun - the Japanese for centuries use iodized products, and 10-15 times higher than the recommended rate, but they are considered one of the healthiest nations on the planet.

Nevertheless, it is necessary to pay attention to a fashionable tendency to use iodine-containing drugs, which are placed on the hopes of curing almost all diseases. Indeed, iodine deficiency can provoke a variety of dysfunctions, but the general addiction to iodides did not reduce the total number of thyroid diseases, unfortunately, the statistics indicate the opposite. Obviously, iodides, like other trace elements, are needed by humankind within reasonable limits, beyond which there is not only an allergy to iodine, but also other ailments.

[1], [2]

Causes of an allergy to iodine

Iodine is a microelement from the family of halogens, that is, low-molecular compounds, which in principle are not capable of being true allergens. However, iodine can react with antibodies - tissue proteins, form an antigenic complex and cause allergy symptoms. Like other dosage forms, iodine is a hapten that accumulates molecular weight through an alliance with high molecular weight protein compounds in the blood of the human body. Actually, the cause of the allergy to iodine is the formation of a conjugated antigen, which provokes sensitization and the symptoms of an allergic reaction. Hapten may be any drug that contains iodides, these include the following:

Inorganic ionic iodides are Kalii iodidum (potassium iodide) and Natrii iodidum (sodium iodide).

• Solutio lodi spirituosa is an alcohol solution of iodine.
• Solutio Lugoli - iodine solution in aqueous potassium iodide solution, Lugol solution.
• Radiopaque preparations (intravascular injection) - lipiodol, urographine, ultravist, biligraphine, hexabrix, iodamide, telebriks and others.
• Drugs for the treatment of diseases of the thyroid gland - microweight, antistrum, thyrecombe, thyrotome, L-thyroxine and others.

• Antiseptic drugs - iodinol, iodovidone, iodoform.
• Antiarrhythmic drugs - amiodarone, sedacorone, cordarone.
• Other groups of drugs, which include solutan, chiniofon, dermazolone (in the form of ointment), algogyl, konplan, miodil.

The causes of an allergy to iodine is a cross-drug allergy that can develop in stages:

1. Transformation of iodine-containing drug (drug) into a form necessary for synthesis with high-molecular proteins.
2. Formation of a full-fledged allergic antigen.
3. Provocation of an allergic reaction from the immune system.

Immunity perceives the antigenic complex as pathogenic and fights it with the help of specific immunoglobulins, releasing more than 20 BAS - biologically active substances. The group of BAS is primarily histamine, then - kinin, heparin, serotonin and other components.

[3], [4]

Symptoms of an allergy to iodine

The most typical manifestations and symptoms of an allergy to iodine are skin rashes, dermatitis. The reaction is so specific that in clinical practice it is called iodine dermatitis or iodine allergic rash. In addition, reddening of localized skin areas in the place of contact with iodine-containing substance, less swelling is possible. If the iodides are inside the body, the reaction is the same as in the case of external contact, manifested on the skin. In such cases, skin manifestations are iodine urticaria. In general, the symptoms of an allergy to iodine can be combined into two groups:

1. Dermatological manifestations:

The expansion of the vessels causes redness of the skin.

• Rash, itching.
• It is extremely rare, with a severe overdose - a multiform erythema pathological or Stevens-Johnson syndrome.
• Even less common is Lyell's syndrome, a toxic bullous dermatitis caused by an allergy to iodine. Most often single cases are associated with the introduction of radiopaque substances.

2. Systemic allergic manifestations:

• Shortness of breath, shortness of breath.
• Erythema of facial skin.
• Swelling of the face.
• Angioedema.
• Edema of the Quincke.
• Bronchospasm.
• It is extremely rare - anaphylaxis, which is considered pseudoallergic complications and is diagnosed as anaphylactoid shock.

The allergy to iodine symptoms demonstrates fairly typical, as a rule, they do not threaten the health and life of the patient, especially if the allergic reaction is caused by food products (sea kale, sea fish). Complications are possible only with the internal use of medicinal iodine-containing drugs, severe clinical manifestations are characteristic only with the introduction of radiopaque preparations.

How does the allergy to iodine manifest itself?

Most often in clinical allergological practice, there is a so-called iodism - side effects of an allergic reaction to iodides. The mucous membranes and skin integuments react first, and the more burdened symptomatology is possible with a strong overdose of iodine-containing drugs.

1. A characteristic taste of metal in the mouth.
2. Painful sensations in the gums, teeth.
3. Burning sensation in the airways in the mouth.
4. Increased salivation (hypersalivation).
5. Tear, swelling of the eyes.
6. Allergic rhinitis.
7. A characteristic rash in the form of iodine acne is papular, pustular rash on the skin of the face, less often on the body.
8. Very rarely occurs iododerma - toxic dermatitis in the form of extensive blisters, erythema, purpura (subcutaneous capillary hemorrhage).

How to check for an allergy to iodine?

How to check there is an allergic reaction to iodine-containing drugs? At home, you can conduct a safe test, indicating whether the body needs iodides or an allergic response of the immune system is possible. Iodine (alcohol tincture) is applied with a cotton swab on the forearm or on the surface of the thigh (inner side). It is enough to draw several lines, or make a small "grid", which should disappear within a day or earlier. If iodine is completely absorbed through the skin and leaves no trace on it, hence any iodine-containing drug will be perceived quite normally, without complications in the form of allergic manifestations. If in the place where the lines were applied, reddening of the skin began, you should stop any contact with iodine and in the future always warn doctors that individual intolerance to iodine preparations is possible. Iodine may not be absorbed into the skin, but if there are no rashes on it, it does not itch, does not redden, which means that the body simply does not need an additional dose of iodides.

How to check for allergy to iodine in a medical institution? Before the diagnostic procedures involving the introduction of radiopaque substances, the doctor will necessarily find out the allergic predisposition and the possible risk of the development of adverse reactions to the drug. Before the introduction of radiopaque means, a sample is made on it, necessarily in stationary conditions. The drug is administered intravenously in a small dose - no more than 2 milliliters. If the allergy to iodine does manifest itself in the form of severe symptoms, they are quickly stopped, and the diagnosis is made using more expensive but safe contrast agents that do not contain iodides. Also, if the need for a diagnostic intervention is vital, antihistamines (glucocorticosteroids) are prescribed before the procedure.

In addition, clinicians know that there are chronic diseases that can become a factor that provokes an allergic reaction to iodine-containing medicines. For these ailments, tests and tests are not needed, every doctor is familiar with the list and with caution appoints iodides to patients who have a history of the following diseases or conditions:

• Bronchial asthma.
• Cardiovascular diseases involving beta-adrenoceptor (beta-blockers) - hypertensive disease, coronary heart disease - ischemic heart disease, heart failure, angina and other pathologies.
• Hidden hyperthyroidism.
• Patients over 60 years of age with neurological disorders.

Diagnosis of an allergy to iodine

Symptoms of pseudoallergia are very similar to the manifestations of a true allergic reaction, so the diagnosis of an allergy to iodine requires differentiation. Evaluation of the clinical picture often does not provide complete and accurate information, it is supplemented by various studies, tests of the sample.

1. The doctor collects anamnestic information, including allergological information. The patient needs a detailed report on any atypical reactions to medications, among which there may be iodine-containing drugs. The list of drugs (medicines) should include literally all the means used - from tablets to eye drops or laxative phytonostasis.
2. The doctor determines the time, the period between taking iodides or iodine-containing food and allergy manifestations. As a rule, primary symptoms develop several days after iodine intake. Much less often the reaction occurs in 30-60 minutes, this is a direct evidence of the already occurred sensitization and repeated aggressive reaction of the immune system to a familiar antigen.
3. Diagnosis of allergy to iodine involves finding out the causes and ways of administering an iodine-containing substance. It can be an external preparation, a medicine in tableted or injectable form or food. The way of introduction of iodides into the body and their dose are important parameters for confirmation of the diagnosis - allergy to iodine.
4. The patient is given elimination tests, samples in which all drugs are temporarily canceled. If the patient makes complaints about allergies to iodides, they are canceled first, in addition, an elimination diet is appointed, which excludes any kind of seafood. With iodine intolerance after elimination all unpleasant symptoms subsided, which confirms an allergy to iodine-containing substances.
5. If the diagnosis is difficult due to the polysymptomatics characteristic of cross-allergy, skin tests are prescribed. Samples for iodine - is the application of meshes, lines, applications on the forearm, less often on the inner surface of the thigh. As a rule, allergic manifestations are visible after 4-6 hours, sometimes even earlier, possibly redness of the skin, sensation of itching.

Diagnosis of allergy to iodine with the introduction of radiocontrast drugs is mandatory, even if the patient does not make complaints of an allergic nature. The risk of rapid development of bronchospasm, anaphylaxis during the procedure with the use of contrast preparation is great, the test for iodine tolerance helps to avoid potential complications.

Treatment of allergy to iodine

The actions to stop the allergic reaction to iodine components are quite typical and are as follows:

1. Treatment of an allergy to iodine is the immediate withdrawal of all iodine-containing drugs. Elimination is the most effective way to quickly reduce and neutralize allergy manifestations. If there is a suggestion that the symptomatology indicates a cross-drug allergy, the drug that does not play an important role in the overall therapeutic purpose is canceled and its withdrawal does not worsen the patient's condition. 2.
2. Symptomatic treatment of an allergy to iodine is the appointment of antihistamines according to the clinical picture. The choice of the drug and its form are directly related to the allergy clinic. In severe complications such as bronchospasm, anaphylaxis, which is most often called an anaphylactoid reaction to iodine, symptom relief is performed according to the standard scheme.

If the allergy to iodine is manifested as iodism, the following scheme is assigned:

• Abolition of preparations containing iodine.
• Antihistamines in tableted or injectable form, depending on the manifestation of an allergic reaction.
• Intravenous administration of calcium chloride, with uncomplicated symptoms - taking CaCl2 orally on a tablespoon 2-3 times a day.
• Gentle fractional diet, excluding seafood and iodized salt.
• Enterosorption with the appointment of Enterosgel, activated carbon.
• Restoration of the microflora of the digestive tract with the appointment of enzymatic preparations and eubiotics (bifiform, lactobacterin).
• External antihistamine, antipruritic drugs in the form of ointments (corticosteroids), talkers, aerosols.

Treatment of allergy to iodine is primarily a relief of the most uncomfortable symptoms, which include skin reactions. Intolerance to iodine in the form of contact dermatitis is much more common than pseudo-allergy to radiocontrast preparations. With cutaneous manifestations of allergies, it is necessary to thoroughly wash the skin and take an over-the-counter medication from the antihistamines group. When diagnosing with RCC (radiopaque means), the relief of symptoms and complications is carried out directly in the medical institution, which is not difficult, since the medical staff is in principle ready for such actions. It should also be noted that when carrying out choledochography, urography, angiography, an iodine allergy is found in just 1 case per 10,000 procedures.

Prevention of allergy to iodine

Preventative measures for LA (drug allergy), which includes iodine intolerance, is the only reliable way to avoid potential complications. If a patient has a history of an allergic predisposition, any competent doctor will take this information into account when prescribing diagnostic procedures and basic therapy.

Preventing allergies to iodine are the following rules:

1. Collecting allergological anamnesis, including family, hereditary.
2. Exclusion of prescriptions and intake of iodine-containing drugs.
3. Exclusion of prescription drugs with similar antigenic, immunogenic properties taking into account the risk of cross-allergy (the whole halogen group is fluorine, iodine, chlorine, bromine).

Consideration of obvious contraindications to the appointment of iodides or diagnostic procedures using contrast agents. If possible, procedures should be replaced, or with care to conduct angiography, urography and other diagnostic measures with the introduction of radiopaque in the following conditions, pathologies:

• Hemorrhagic vasculitis.
• Pregnancy.
• Leukopenia.
• With caution in hyperthyroidism, thyrotoxicosis.
• Adiposo-genital (pituitary) obesity.
• Diabetes mellitus in severe form.
• With caution in bronchial asthma, atopic dermatitis.
• Arrhythmia, heart disease, heart failure, angina, coronary heart disease (ischemic heart disease).
• With caution in hypertensive disease.
• Pulmonary edema.
• Hypercoagulation, dehydration (dehydration).
• Severe kidney disease, kidney failure.

Prevention of allergy to iodine is not difficult, most often intolerance of iodides is neutralized by the rejection of a few drugs or foods that are not vital.